More than half the managed-care executives interviewed in a recent survey consider hospital groups that establish managed-care organizations one of the biggest threats to HMOs.
One-third of the executives said they view physician groups as competitors rather than allies.
The telephone survey of 229 executives from 40% of the nation's 574 managed-care organizations was conducted last fall by the Response Center, a Philadelphia-based healthcare market research firm.
The survey also measured the attitudes of 400 consumers on a range of healthcare issues.
"Our goal was to provide a snapshot of the healthcare `executive mind' on a wide spectrum of issues" and to have a consumer perspective on the same issues, said Patrick M. Baldasare, president of the Response Center, in a written statement.
Healthcare executives agree (53%) that hospital systems establishing managed-care organizations are one of the biggest competitors to HMOs. Thirty-six percent of executives agree that "physician groups are more of a competitor to HMOs than an ally," the study said.
Healthcare executives agree more strongly than consumers that health insurance should cover AIDS-related treatment (80% vs. 73%) and ailments related to chronic smoking (67% vs. 55%).
Consumers (54%) are more likely than executives (11%) to agree that experimental treatments should be fully covered.
Despite the complexities of capitation, 76% of executives said it's an effective strategy for containing costs.
Similar numbers of consumers and executives (70%) agree that healthcare coverage should be available to all Americans.
Fewer healthcare executives (32%) than consumers (56%) agree that all businesses should be mandated to provide employee healthcare coverage.
These results may indicate that executives feel such a mandate would pose a double threat: It would force HMOs to provide coverage to small businesses, and small managed-care organizations would spring up to provide that coverage, the study said.