The Impact of Prepaid Group Practice on American Medical Care: A Critical Evaluation

This paper examines the concept of prepaid group medical practice, evaluating its principles and assessing the relevant data. Various features of this health care alterna tive are shown to offer potential for control of quality and efficiency. Group medical practice has been shown to reduce hospitalization rates and to diminish markedly what can be viewed as unnecessary surgery. Judging from the high pro portion of eligible members who receive some form of care each year, accessibility seems to be improved. The use of appro priate preventive services by the members seems higher than in other types of medical care arrangements. To some extent this system appears to minimize the duplication of effort, personnel, and facilities that characterizes the individual fee- for-service system. In terms of over-all cost savings and the ability to provide high quality care with patient satisfac tion, prepaid group practice seems to offer major advantages over other systems. The paper examines its efficiency from the standpoint of the requirements necessary to provide service to an entire population.