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Results for “Antitrust Laws”

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At least 415 records · Page 23Linked to original sources
PubMed1996

Managed care and the infectious diseases specialist.

There is growing demand to contain health care costs and to reassess the value of medical services. The traditional hospital, academic, and research roles of the infectious disease (ID) specialist are threatened, yet there is an increasing need for expertise because of growing antimicrobial resistance and emerging pathogens. Opportunities exist to develop and expand services for the care of patients infected with human immunodeficiency virus and in infection control, epidemiology, outcomes research, outpatient intravenous therapy, and resource management. It is important for ID physicians to appreciate the principles involved in managed care and the areas in which ID services can be valuable. To be effective, physicians need to know about tools such as practice guidelines, physician profiling, outcomes monitoring, computerized information management, risk sharing, networking, and marketing, as well as related legal issues. With a positive attitude toward learning, application, and leadership, ID physicians can redefine their role and expand their services through managed care.

Ambulatory Care↗
PubMed1995

The response of the dominant firm to competition: the Ocean State case.

The Ocean State antitrust case illustrates the operation of the competitive marketplace in health insurance. Blue Cross, the dominant firm in Rhode Island, responded competitively to the entrance of a new competitor, Ocean State, in three ways: 1) a most-favored-nation clause, 2) creation of a PPO offering similar benefits as Ocean State, and 3) an adverse selection policy. These actions are assessed to be legitimate competitive responses and the decisions of the higher courts overturning the jury verdict against Blue Cross are supported.

Antitrust Laws↗
PubMed1992

Legal reality for physicians.

The practice of medicine as we have known it is rapidly becoming a "dinosaur" giving way to more complex business and legal relationships among physicians. Quality medical care, however, does not have to become obsolete. As physicians begin to collaborate with each other to survive and thrive in an increasingly competitive environment, their collective influence over payors and other guardians of the cost of health care should focus on ensuring the preservation of quality medical care. By minimizing the adverse consequences of administrative burdens on individual practices, physicians should be able to maximize their practice efficiency and earning potential while preserving their goal of providing quality medical care.

Antitrust Laws↗
PubMed1996

Emerging state policy trends related to medical group practice: Alpha Center.

This article examines how state health care policy affects new ventures involving medical group practices. It will review briefly traditional state authorities related to the health care sector in general and physician organizations in particular. The article will then discuss state policies related to a range of physician organizations, including those aligned with larger provider systems. State policies related to physician organization in the competitive marketplace include several topics: referral practices, tax exemption, corporate practice of medicine, and antitrust and insurance regulation. Finally, it will discuss the implications of these trends for future enterprises undertaken by medical group practices.

Antitrust Laws↗
PubMed1997

Linking primary care centers and hospitals.

Primary care centers (PCCs) are increasingly entering into linkages with hospitals that go far beyond the traditional arrangements in which the hospitals serve as backups to the PCCs. The linkages can be for managed care purposes, for training of health professionals in primary care settings, or for other reasons. This article explores the advantages of such arrangements, the organizational forms that the linkages can take, the legal issues, and negotiating the deal.

Antitrust Laws↗
PubMed1996

A tripartite regulation of health networks.

With the Republicans in power, market-driven forces of managed care plans, capitated payment, and the regional networks (alliances) are likely to serve as centerpieces for improving the organization, financing, and delivery of our nation's health services. These "voluntary" alliances of health providers and health insurance underwriters foreshadow the powerful, geographically linked regional health networks that are now becoming oligopolies. As a result of these providers developing monopolistic practices, state health services commissions will be formed to regulate market share, the scope of health services, reimbursement rates, and profits. State departments of public health will continue to focus on broader community health initiatives such as access and quality. Complexities of relationships among those regulated by these responsible agencies, and the interfacing of these state health services commissions and state departments of public health and insurance, with their potentially conflicting goals and political forces, are expected.

Antitrust Laws↗
PubMed1995

Antitrust implications of health care reform.

Antitrust issues affect the insurance industry, hospital industry, and physicians. The authors explore the history of antitrust issues in the health care field and implications for future developments. Interest in antitrust has increased due to current merger and acquisition activities in the industry. With the failure of the Health Security Act, health care reform will be left to private industry. Will there be increasing or decreasing antitrust activity by the Department of Justice and Federal Trade Commission?

American Medical Association↗
PubMedDate not supplied

Restraint of trade implications for nurse practitioners: denial of hospital admitting or staff privileges.

Denial of hospital admitting or staff privileges can limit the practice of a nurse practitioner. The Sherman Antitrust Act (1982) with restraint of trade stipulations has been used successfully by nonphysician health care providers to gain hospital admitting and staff privileges. Cases are discussed to offer examples to nurse practitioners for a potential legal recourse for gaining desired privileges.

Antitrust Laws↗