Social/Health Maintenance Organization and Fee-for-Service Health Outcomes OverTime

Evaluating the performance of long-term care (LTC) demonstrations requires longitudinal assessment of multiple out-comes where selective mortality and dis-enrollment, if not accounted for, can give the appearance of reduced (or enhanced) efficacy. We assessed outcomes in social/ health maintenance organizations (S/HMOs) and Medicare fee-for-service (FFS) care using a multivariate model to estimate active life expectancy (ALE). S/HMO enrollees and samples of FFS cli-ents in four sites were analyzed and out-come differences assessed for a 3-year period. Results provide insights into S/HMO performance under different con-ditions and, more generally, into evaluat-ing LTC demonstrations without random-ized client and control groups