State legislatures are gradually changing the care that patients potentially receive from health maintenance organizations (HMOs). What is one means by which this improvement has occurred?
1. States have set the premiums that enrollees pay for HMO coverage.
2. States have mandated how many HMOs will operate within the state.
3. States have mandated that all citizens be covered by HMOs if that is the desire of the citizen.
4. States have allowed patients who receive substandard care to successfully bring suit against HMOs.
4
Rationale: Allowing patients to successfully bring suit against HMOs has made the HMOs accountable for their practices by applying state statutes and laws that would apply to other insurance providers. States do not set premiums or mandate that all citizens must be covered by the HMOs. Mandating numbers of HMOs operating within the state would not improve quality of care as much as holding HMOs accountable for practice decisions and actions.
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