Do HMO and its for‐profit expansion jeopardize the survival of hospital safety net services?
研究了1990至2004年间健康维护组织及其营利性份额对医院安全网服务关闭风险的影响，发现营利性HMO扩张会增加部分安全网服务的关闭风险，对政策制定者有参考价值。
This study examines the effect of health maintenance organizations (HMOs) and for-profit HMO share on the survival of safety net services in hospitals between 1990 and 2004. The primary data sources are the American Hospital Association Annual Surveys, the Medicare hospital cost reports, and the HMO enrollment and ownership data from Interstudy. I analyze the risks of shutting down each safety net service separately using the proportional hazard models. I find that the risks of shutting down hospital safety net services do not vary by different levels of overall HMO penetration. However, conditional on the overall HMO penetration level, increasing for-profit presence of HMO does increase the risks of shutting down several safety net services. Policies evaluating the for-profit expansion or ownership conversion of health plans should take this potential adverse effect into consideration.