Of the two main types of health maintenance organizations (HMOs), IPA / network HMOs (which contract with an independent practice association (IPA) and other medical groups) grew faster than the group / staff HMOs (which is the exclusive partner of multi-specialty medical groups or hire staff physicians). However, as the IPA / network HMOs in California contract with wide and overlapping networks of doctors and hospitals to meet the demand of customers, these measures suffer from inefficiencies that impasse and disrupt physicians and consumers, and these mechanisms do not provide the highest quality, most- economic assistance. This article discusses the historical context and the growth of managed care in California, and then outlines the performance problems associated with overlapping network of IPA / network HMOs. The authors also consider the various possible strategies to address these issues, and discuss the advantages and disadvantages of each option. "Hide
by Sara J. Singer, Alain C. Enthoven Source: California Management Review 17 pages. Publication Date: 01 Oct 2000. Prod. #: CMR186-PDF-ENG
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