Health care delivery systems in review.

Health maintenance organizations (HMOs) continued to show financial distress throughout 1987, primarily due to higher utilization of outpatient services, rising costs of technology, and management of facilities. On the state level, concern over insolvent HMOs is resulting in proposed legislation for guaranty funds to ensure patient care and provider payment in the event of a bankrupt HMO. Ev en in light of these challenges, HMOs and their enrollment continue to climb, although not a past rates.