Mandatory work in Quebec.

This Policy Brief examines the viability of introducing private competition into the Medicare program by studying the availability of Medicare+Choice (M+C), commercial HMO, and Federal Employees Health Benefits Program (FEHBP) plans in rural (nonmetropolitan) counties. The Brief also presents evidence regarding the variables that influence plan availability and impact plan choice across counties in the U.S. The findings in this Brief will be useful to policymakers considering using a competitive model to design a Medicare prescription drug benefit or to redesign the entire Medicare program. As changes in the Medicare program are considered, the information in this Brief will provide background regarding rural participation in earlier Medicare program changes and in other programs said to be models for change.

Economic Competition↗

PubMed2003

Markets and medicine: barriers to creating a "business case for quality".

Systematically improving the quality of medical care requires the creation and implementation of organized processes by health plans, hospitals, and physician groups. But to a considerable extent the medical market in the United States financially penalizes organizations that invest in improving quality, rather than rewarding them. This article explores the ways in which the market as presently constituted fails to reward investments in quality improvement and describes efforts newly underway to create a "business case for quality." It briefly suggests measures to that could be taken by public and private policymakers--by government as purchaser and regulator of medical care, and by large employers who in effect make policy through their health insurance purchasing decisions--to create a business case for quality.

Economic Competition↗