HMOs are looking to keep long-term clients, especially if they are staying healthy and avoiding the cost of future care. Both HMOs and patients see preventative care as important. So HMOs provide interim care and encourage preventative measures, like pap smears and cholesterol screening. But if the client changes health plans, the investment is not going to pay off, and the HMO's incentive for interim care is reduced. The patient's health, though, is also the concern of the HMO, not just for financial reasons.
Physicians are concerned with providing patients with the best care possible.
An enigma emerges here. The HMO is both advocate for the patient and watchdog for expenditure. And it is at the mercy of the patient's choice. The HMO is, by definition, a bit muddled. And often, it leaves its clients, like those at the University, in a lurch.