Luft H S
Milbank Q. 1986;64(4):566-91.
The focus of interest in HMOs is shifting from simple encouragement of their growth to the design of systems allowing for choice among alternative plans. Problems of adverse and favorable selection of enrollees may prevent effective multiple choice. A trial system, including enrollee surveys and risk pools, is proposed to create incentives for delivery systems to compete on the basis of efficiency and services rather than on selection.
健康维护组织（HMOs）的关注焦点正从单纯鼓励其发展，转向设计能让人们在不同方案中进行选择的系统。参保人员逆向选择和顺向选择的问题可能会阻碍有效的多种选择。本文提出了一个试验性系统，包括参保人员调查和风险池，旨在促使医疗服务提供系统基于效率和服务而非选择来展开竞争。
