Overview of the HMO movement.

This article provides a short historical review of the HMO movement to set the stage for current HMO developments. It notes the underlying causes of the proliferation of HMO managed care models. It defines what should be the rudiments of a quality HMO program and how the changing societal environment will bring new pressures to bear on HMO programs of the future. As related to the future, the author outlines a direction for national health care reforms. The article concludes that the health care emphasis of the 90s should be in returning some of the responsibility of health care to individual Americans through self-care programs that focus on behavioral change, in turn, leading to healthier Americans, the keys to containing out of control health care costs.