HMOs may be making death more merciful for elderly patients, researchers say.
Although the cost-cutting practices of health maintenance organizations are sometimes criticized as harmful to patients, a new study has found that Medicare patients in HMOs were less likely to get prolonged, costly - and ultimately futile - care than those with traditional Medicare coverage.
"If we can avoid these kinds of outcomes, which have suffering associated with them, we can improve the quality of care-giving," said Dr. Leslie Lenert, the study's co-author. Skeptics said that the data may underestimate the cost of treating HMO patients and that Medicare beneficiaries who choose HMOs may be people who would decline aggressive care at life's end anyway. In the study, based on 1994 data, Medicare patients hospitalized in intensive care units in California were 25 percent less likely to undergo aggressive, highly expensive care that ultimately proved futile if they were HMO members than if they were covered by fee-for-service reimbursement. The HMO patients did not die at a higher rate while hospitalized and died at only a slightly higher rate - 8 percent - in the 100 days after release. …