Dr. Paul M. Ellwood Jr., HMO architect, dies at 95.

In the 1960s, while still working for the American Rehabilitation Fund, Dr. Ellwood formed a health policy research group called Interstudy that studied ways to apply business management practices to improve health care and reduce costs. She created HMO, which years later became the United Health Group, now one of the nation’s largest healthcare companies.

In the early 1970s, Dr. Ellwood abandoned his medical career to move to Wyoming, go into real estate, and found the Jackson Hole Group, a group of doctors, economists, scientists, and politicians who periodically met at his home for decades to discuss new health care strategies.

The group produced many reports, but the most notable one was used by Bill Clinton in his 1992 presidential campaign, when he promised to reform the health care system of runaway spending and uninsured millions. After Mr. Clinton’s election, dr. Ellwood, economist Alain S. Enthoven, and others developed an outline for the administration’s “managed competition” health care reform proposal.

This would bring businesses and individuals into cooperatives to buy insurance from partnerships of doctors, hospitals, and insurance companies competing for business, and reach nearly all uninsured Americans. Hillary Clinton’s plan failed in 1994, but by then Dr. Elwood and his colleagues distanced themselves from the plan due to conflicts over the levels of regulation it would have to introduce.

Dr. Ellwood, who lived in Bellingham, north of Seattle, stepped down as president of the Jackson Hole Group in 2002. He and his first wife, Elizabeth Ann (Schwenk) Ellwood, had three children: Deborah, Cynthia and David. They divorced in 1990 and Elizabeth Ann later died. In 2000, he married Barbara Winch. In addition to his wife, D. Elwood is survived by three children and five grandchildren.

In later years, he championed what he called “results management,” a national database showing how patient care actually works. He argued that without such measures, health care providers and policy makers would not be able to know if there was a trade-off to cut costs and would not be able to evaluate reform proposals.