Am J Psychiatry 1988; 145:1544-1549
Copyright © 1988 by American Psychiatric Association
The greening of the HMO: implications for prepaid psychiatry
MJ Bennett
Teaching Center, Harvard Community Health Plan, Boston, MA.
Over the past 15 years the health maintenance organization (HMO) movement
has abandoned its social objectives in favor of economic ones. The early
emphasis on making equitable and affordable health care available to
populations has been superseded by concerns about profitability, market
share, and consumer appeal. Psychiatric services, which came late in the
HMO movement, were characterized by common values and priorities in the
closed-panel HMOs of the 1970s. Trends toward independent practice
associations (IPAs) and other open-panel systems, rising expectations, and
the monetarization of health care are forcing prepaid psychiatrists to
reassess their identity and roles.
