GERIATRICS IN MANAGED CARE*: Essential Components of Geriatric Care Provided Through Health Maintenance Organizations The HMO Workgroup on Care Management

Authors:
  • KBKenneth V. Brummel‐Smith
    Kenneth V. Brummel‐Smith
  • PFPeter D. Fox
    Peter D. Fox
  • TMThe HMO Workgroup on Care Management
    The HMO Workgroup on Care Management
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Abstract
The rapid growth in the number of older adults enrolling in health maintenance organizations (HMO) presents a number of opportunities and challenges. Older HMO enrollees have needs that differ from those of younger enrollees, such as the medical conditions they face, their likelihood of having functional deficits, and differences in their living arrangements. In addition, their health‐related needs often extend beyond medical care and may include relationships with families, caregivers, and community agencies. This article describes the types of services that should realistically be available to older adults who are enrolled in an HMO with a Medicare risk contract in order to meet the goals of geriatric care: to promote health, independence, and optimal functioning, to prevent avoidable decline in health status, and to enhance quality of life. The findings are based on deliberations during the past year by the HMO Workgroup on Care Management, which was convened under the auspices of The Robert Wood Johnson Foundation's national program, “Chronic Care Initiatives in HMOs.”

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