One of these institutions contracts with its Medical Staff IPA through a PHO jointly owned by the IPA, the medical school and the academic medical center hospital. At a Midwestern respondent, the provider panel is composed primarily of university physicians and facilities. Contracting primary care community physicians can obtain clinical privileges at the university hospitals to care for their patients enrolled in the plan. Four additional respondents use both their own as well as community providers. While faculty physicians comprise the largest provider groups for two respondents' HMOs for staff and dependents, both plans maintain contracts with large numbers of community hospitals and physicians throughout their HMOs' service areas.
Specialists are on individual contracts in both areas.
Meeting Teaching and Research Missions Four respondents reported that their HMO settings and patients are used for teaching and research activities. Four respondents reported that to date little or no teaching occurring in their HMO settings. One of these reported that the role of the new full-service in the teaching has not yet been defined, but that it will likely be used to help trainees and medical students adapt to the managed care environment. A medical school in the South reported that its two HMOs are just beginning to play a role in the institution's education and research activities. At another Southern respondent, several managed fellowships are offered for faculty.