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Results for “Managed Competition”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

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At least 757 records · Page 42Linked to original sources
PubMed1992

Kenyan team care at the Special Olympics--1991.

The Kenyan team that competed at the International Summer Special Olympics comprised 38 athletes (both men and women) selected from all competitors at the national championships. The team was examined and a physiological fitness test carried out. The results enabled the organizers to arrange for treatment of prevailing illnesses, and the training programme was adjusted to the athletes' level. This team was voted the best team of the month of July, having won 33 gold, three silver and two bronze medals. Sound medical care of athletes should be taken before and during competition. Such management should aim at minimizing injuries and enabling athletes to perform at their best.

Adolescent↗
PubMed1997

Managed behavioral health care premises, accountable systems of care, and AMBHA'S perms. American Managed Behavioral Healthcare Association.

This article discusses the concepts and approaches underlying managed behavioral health care and the need to assess quality of care. The author describes the Performance Measures for Managed Behavioral Healthcare Programs (PERMS) developed by the American Managed Behavioral Healthcare Association (AMBHA), which is offered as a first step toward enhanced quality of care assessment in managed behavioral health care.

Behavioral Medicine↗
PubMed1996

Salutogenic psychosocial nursing practice.

Public affirmation of core principles for relating with clients is needed in order to assure continued viability of quality nursing practice in this era of competition and managed health care. Practitioners of professional nursing can reassert their legitimate claim to quality nursing care through an emphasis on the practice of salutogenic psychosocial nursing. The presumption is that clients, families, and communities who benefit from salutogenic nursing care are more likely to heal and stay well because they have developed competencies for managing the details of their health situations. This paper presents key characteristics of salutogenic psychosocial nursing, along with their implications for assuring quality nursing practice.

Environment↗
PubMed1999

Choice and representation in health care.

Choice is often thought to be critical in health care, especially to foster quality improvements and lower costs. However, it is also recognized that in the current system there is significant representation of consumers, members, and patients by physicians, employers, and health plans. Consent, accountability, and protections against conflicts of interest are necessary to ensure legitimate and effective representation. This article discusses the roles and responsibilities of physicians, employers, and other parties with respect to serving as representatives of health care consumers. The author concludes that to make representation more legitimate and effective in health care will require significant changes, which include (1) changing business to a stakeholder theory, (2) involving employees in health care coverage decisions, and (3) involving members of health plans in policy decisions.

Attitude to Health↗
PubMed2001

Privatization of local health department services: effects on the practice of health education.

Local health departments (LHDs) are changing service delivery mechanisms to accommodate changes in health care financing and decreased public support for governmental services. This study examined the extent to which North Carolina LHDs privatized and contracted out services and the effects on the time spent on core functions of public health and activities of health educators. Questionnaires were mailed to the senior health educators in all LHDs. Sixty-nine responded, and 68% of LHDs had not privatized any services other than laboratory and home health. Clinical services were more commonly privatized than nonclinical services. Respondents perceived that privatization produces more time for LHDs to address the core public health functions and for health educators to engage in appropriate professional activities. Health educators in LHDs that had not privatized were more likely to be concerned about potential negative effects. This study suggests that privatization has generally had a positive effect on the roles of health educators in North Carolina LHDs.

Contract Services↗
PubMed1997

The technocratic wish: making sense and finding power in the "managed" medical marketplace.

Enormous changes have recently swept through the organization and delivery of medical care. Scholars and students of the health care system and its politics try to make sense of the shift in power to identify and allocate needed resources away from physicians and toward corporate firms. I suggest that we cannot understand managed care unless we understand its power as at least substantially due to its reliance on a claim to be better science. In this way, managed care needs to be placed within an analytic historical tradition that is concerned with how accounts of scientific objectivity become convincing and support (and are confirmed as scientific by) social and political objectives. In this way, managed care reflects what I call the technocratic wish: an appeal to objective measures to resolve contentious issues and/or clothe their resolution as scientifically logical and natural.

Evidence-Based Medicine↗
PubMed1997

Markets, Medicare, and making do: business strategies after national health care reform.

This essay examines the role of business health care purchasers in keeping market solutions at the center of the health system. One might assume that employers would have a clear ideological preference for market solutions, but big business managers are ambivalent about market interventions at both the firm and public policy levels. Although currently enthusiastic about market-oriented managed care, large employers have been periodically disappointed by firm-level market experiments during the past two decades. They viewed with skepticism the Republican proposal to apply private-sector market cures to the public Medicare and Medicaid, fearing that the proposals would accelerate cost-shifting to private business payers. Big business objections have been muted, however, by the organizational weakness so vividly illustrated during the national health reform debate.

Commerce↗
PubMed1997

Markets and public programs: insights from Oregon and Tennessee.

Medicaid is the major national program promoting access to care for low-income populations, but the program also is a federal-state partnership. With costs rising and universal access still a remote objective, many states have turned to market-based strategies involving managed care, with the goals of generating savings for the state, improving access for Medicaid beneficiaries, and sometimes expanding coverage to those who were previously uninsured. Yet Medicaid is a complex social insurance system that over time has been used to finance a variety of needs, often using cross-subsidies. In addition, states vary in both the scope of their Medicaid programs and the sophistication of the skills and resources they can bring to bear in shaping them. Understanding how these influence the ability to implement market-based strategies in Medicaid and what the effects of these strategies appear to be is of crucial importance because most states now include some features of this approach in their programs.

Health Care Reform↗
PubMed1993

Changing competition in health care marketing: a method for analysis and strategic planning.

As the cost and importance of healthcare continue to increase, competition in the medical industry is taking new forms and becoming more intense. The driving trends behind this competition are analyzed in the framework of Porter's Five Forces of Competition Model. The authors then discuss how the widely accepted strategies of cost, differentiation, focus, and domestication can be utilized to counter the implications of these trends and how to capitalize on opportunities in medical practice in the 1990's.

Consumer Behavior↗
PubMed1995

The Medicare reform debate: what is the next step?

Medicare costs are rising faster than projected revenues. Action to close the emerging deficit is inescapable. We propose converting Medicare from a "service reimbursement" system to a "premium support" system. These changes would resemble many that are now reshaping private employer-based insurance. Our reform would encompass not just the "public" Medicare program but also the "real" Medicare, which includes the supplemental plans to which most Medicare beneficiaries have access. Approved plans would have to offer stipulated services. We review numerous technical issues in moving to a new system that cannot be solved quickly and that preclude quick budget savings.

Cost Control↗
PubMed1996

Consumers' sensitivity to health plan premiums: evidence from a natural experiment in California.

A recent policy change by the University of California (UC) provides a unique natural experiment for investigating how consumers respond to financial incentives when choosing health plans. In 1994 UC went from a premium contribution policy that subsidized more costly plans to a policy of contributing a constant dollar amount. As a result, employee premium contributions increased for roughly one-third of university employees. The response to this change in relative prices was strong. Whereas only 5 percent of employees facing constant premium contributions switched plans, roughly one-quarter of those facing premium contribution increases of less than $10 per month switched to lower-cost plans. Higher price increases led to even greater rates of plan switching.

California↗