Coleman J R, Poplaski S C
J Public Health Dent. 1977 Spring;37(2):99-105. doi: 10.1111/j.1752-7325.1977.tb02889.x.
None of the federally qualified HMOs had a fully prepaid comprehensive dental care program. Less than a third of the plans went beyond the then mandated benefits of the Act, and those that did, only provided the benefits on a fee-for-service basis. The more established plans, with enrollments exceeding 15,000 members, offered a full spectrum of services, and have acceptable levels of utilization. There appears to be a relation between size and services offered and overall utilization of the dental services. The general direction HMOs are taking with regard to the scope of services provided is hard to predict because more than two thirds of the HMOs studied were "transitional" HMOs. The more mature plans appeared to be leaning toward fully comprehensive services; however, only the "basic" dental services then mandated by the Act were covered by prepayment. It is difficult to predict how the nearly 200 HMOs now being planned and developed will integrate dental care into their programs, especially when dental care services are no longer required as a "basic health service". Based upon the cautious approaches used by the HMOs now in operation, it appears safe to assume that comprehensive dental care programs will not be offered by HMOs until they are forced to do so by competing health insurance carriers or a dental program provides them with a competitive edge.
没有一家获得联邦资格认证的健康维护组织（HMO）拥有完全预付的全面牙科护理计划。不到三分之一的计划超出了当时该法案规定的福利范围，而那些超出的计划，也只是按服务收费的方式提供福利。规模较大、参保人数超过15000人的成熟计划提供了全方位的服务，且利用率处于可接受水平。牙科服务的提供规模、服务内容与总体利用率之间似乎存在某种关联。由于超过三分之二被研究的健康维护组织是“过渡性”健康维护组织，所以很难预测健康维护组织在服务提供范围方面的总体发展方向。较为成熟的计划似乎倾向于提供完全全面的服务；然而，当时该法案规定的“基本”牙科服务才在预付款范围内。很难预测目前正在规划和发展的近200家健康维护组织将如何把牙科护理纳入其项目中，尤其是当牙科护理服务不再被视为“基本健康服务”时。基于目前运营的健康维护组织所采用的谨慎做法，似乎可以有把握地认为，在没有受到竞争的健康保险公司逼迫，或者牙科项目没有给它们带来竞争优势之前，健康维护组织不会提供全面的牙科护理计划。
