Herrmann T J, Matthews C W, Segadelli L J
J Med Educ. 1983 Sep;58(9):686-94. doi: 10.1097/00001888-198309000-00002.
After 14 years of study, the University of Michigan decided to terminate development of a health maintenance organization (HMO). The process was long and difficult because of the university's need to consider the HMO from the university's perspective of both an employer and a provider. As an employer, the university's early view was favorable and then declined when employee interest was found to be weak and the HMO's impact on the rapidly rising cost of the university's health insurance benefit was determined to be modest. As a provider, the university's view was mixed. In regard to its hospitals, the university's judgment was positive largely because it hoped that HMO incentives might help the hospitals remain viable in the health care delivery environment that was becoming increasingly competitive. From the Medical School's point of view, an HMO was felt not to be desirable because it could put in jeopardy the professional fee revenue used by the school to help underwrite its academic programs, which are the primary source of faculty pride and recognition.
经过14年的研究，密歇根大学决定终止一个健康维护组织（HMO）的开发。这个过程漫长而艰难，因为大学需要从雇主和医疗服务提供者两个角度来考虑HMO。作为雇主，大学最初持赞成态度，但后来发现员工兴趣不高，且HMO对大学医疗保险福利快速上涨的成本影响不大，于是态度转为消极。作为医疗服务提供者，大学的态度则较为复杂。就其医院而言，大学的判断是积极的，主要是因为它希望HMO的激励措施能帮助医院在竞争日益激烈的医疗服务环境中维持生存。从医学院的角度来看，HMO被认为不可取，因为它可能会危及学校用于资助其学术项目的专业费用收入，而这些学术项目是教师自豪感和认可度的主要来源。
