Document Type


Publication Date


Publication Title

BioMed Central Health Services Research


Geisel School of Medicine


To examine how a group practice used organizational strategies rather than provider-level incentives to achieve savings for health maintenance organization (HMO) compared to fee-for-service (FFS) patients. A large group practice with a group model HMO also treating FFS patients. Data sources were all patient encounter records, demographic files, and clinic records covering 3.5 years (1986-1989). The clinic's procedures to record services and charges were identical for FFS and HMO patients. All FFS and HMO patients under age 65 who received any outpatient services during approximately 100,000 episodes of the seven study illnesses were eligible.

Original Citation

Flood AB, Fremont AM, Jin K, Bott DM, Ding J, Parker RC Jr. How do HMOs achieve savings? The effectiveness of one organization's strategies. Health Serv Res. 1998;33(1):79-99.