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Results for “Managed Competition”

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At least 991 records · Page 55Linked to original sources
PubMed1987

A community approach to health care competition.

In the Worcester, Massachusetts, area, a community program is making health care more affordable through competition among managed-care health plans. Business and health care leaders have joined to assure that this competition focuses not only on price but also on quality and service, and that it benefits the entire community, including the elderly, poor, and uninsured. This paper describes the progress of the program to date as well as strategies for overcoming obstacles to further success.

Community Health Services↗
PubMed1995

Optimizing cardiothoracic surgery information for a managed care environment.

The rapid change occurring in American healthcare is a direct response to rising costs. Managed care is the fastest growing model that attempts to control escalating costs through limitations in patient choice, the active use of guidelines, and placing providers at risk. Managed care is an information intensive system, and those providers who use information effectively will be at an advantage in the competitive healthcare marketplace. There are five classes of information that providers must collect to be competitive in a managed care environment: patient satisfaction, medical outcomes, continuous quality improvement, quality of the decision, and financial data. Each of these should be actively used in marketing, assuring the quality of patient care, and maintaining financial stability. Although changes in our healthcare system are occurring rapidly, we need to respond to the marketplace to maintain our viability, but as physicians, we have the singular obligation to maintain the supremacy of the individual patient and the physician-patient relationship.

Capitation Fee↗
PubMed2006

Disease management and health care reforms in Germany - does more competition lead to less solidarity?

Up to the 1990s German health care legislation was dominated by measures regulating the supply side. Measures, such as budgets, aimed at volume control and sought to confine the increase of health care spending to the growth of the national income. To curb costs more effectively, competitive elements were introduced in the 1990s with free choice of sickness funds (open enrollment). To balance competition and solidarity, a risk compensation scheme (RCS) was implemented two years prior to open enrollment. Since then, balancing competition and solidarity has been a key feature of all consecutive health care reforms. The implementation of disease management programs in the statutory health insurance (SHI) served the dual purpose to promote quality of care and to foster competition. Preliminary experiences suggest, that the aligning of disease management programs with a RCS can greatly aid its implementation and benefit solidarity and competition.

Delivery of Health Care↗
PubMed2001

Competition in hospital and health insurance markets: a review and research agenda.

OBJECTIVES: To review the empirical literature on the effects of selective contracting and hospital competition on hospital prices, travel distance, services, and quality; to review the effects of managed care penetration and competition on health insurance premiums; and to identify areas for further research. PRINCIPAL FINDINGS: Selective contracting has allowed managed care plans to obtain lower prices from hospitals. This finding is generalizable beyond California and is stronger when there is more competition in the hospital market. Travel distances to hospitals of admission have not increased as a result of managed care. Evidence on the diffusion of technology in hospitals and the extent to which hospitals have specialized as a result of managed care is mixed. Little research on the effects on quality has been undertaken, but preliminary evidence suggests that hospital quality has not declined and may have improved. Actual mergers in the hospital market have not affected hospital prices. Much less research has been focused on managed care markets. Greater market penetration and greater competition among managed care plans are associated with lower managed care premiums. Greater HMO penetration appears to be much more effective than PPO penetration in leading to lower premiums. While workers are willing to change plans when faced with higher out-of-pocket premiums, there is little evidence of the willingness of employers to switch plan offerings. Preliminary evidence suggests that greater managed care penetration has led to lower overall employer premiums, but the results differ substantially between employers with and without a self-insured plan. CONCLUSIONS: Much more research is needed to examine all aspects of managed care markets. In hospital markets, particular attention should be focused on the effects on quality and technology diffusion.

California↗
PubMed2002

Managed care and the US health care system a social exchange perspective.

Many countries are importing managed care and price competition from the US to improve the performance of their health care systems. However, relatively little is known about how power is organized and exercised in the US health care system to control costs, improve quality and achieve other objectives. To close this knowledge gap, we applied social exchange theory to examine the power relations between purchasers, managed care organizations, providers and patients in the US health care system at three interrelated levels: (1) exchanges between purchasers and managed care organizations (MCOs); (2) exchanges between MCOs and physicians; and (3) exchanges between physicians and patients. The theory and evidence indicated that imbalanced exchange, or dependence, at all levels prompts behavior to move the exchange toward power balance. Collective action is a common strategy at all levels for reducing dependence and therefore, increasing power in exchange relations. The theoretical and research implications of exchange theory for the comparative study of health care systems are discussed.

Delivery of Health Care↗
PubMed1997

Managed change. HMOs, PPOs in flux as buyouts, mergers, competition take a toll on the market.

While some provider-owned managed-care plans have sold to investor-owned companies, most aren't as bottom-line oriented, according to Modern Healthcare's HMO/PPO Survey. Even plans that lost money last year are investing in information systems, new products, geographic expansion and mergers with other provider-owned plans. Several survey respondents are market leaders that have won national recognition.

Economic Competition↗
PubMed1995

Managed care.

Explore the source record for details and available documents.

Economic Competition↗
PubMed1995

Managed care.

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Economic Competition↗
PubMed1995

High tech home care: surviving and prospering in a changing environment.

Managed care plans are expanding rapidly into new marketplaces. Reimbursement for home infusion therapy, including parenteral and enteral nutrition, is significantly affected under managed care, especially when capitated payment mechanisms are used. Home care companies have experienced downsizing, mergers, acquisitions, and fierce competition in the managed care environment. Clinicians who are entering the home care setting may find that, in addition to clinical expertise, their marketability depends on a set of new skills and abilities in order to prosper in this new environment.

Home Care Services↗
PubMed1993

Building a strategic technology management program.

Strategic technology management decisions are one of the best opportunities for healthcare providers to positively meet clinical needs, patient expectations and competitiveness goals. Technology management must not be treated as an event (annual capital budgeting) but as a well-thought-out, long-range business plan. A strategic technology management team should be formed that includes all the key strategic business areas, plus ad hoc members from the clinical and biomedical engineering areas. Current and future needs should be assessed and the performance of the plan monitored. A plan will help achieve buy-in from clinicians and reduce unwarranted expenditures on technology.

Budgets↗
PubMedDate not supplied

Academic health centers in competitive markets.

Academic health center (AHC) hospitals and other major teaching hospitals have funded a portion of their academic missions through patient care revenues. Using all-payer state discharge data, this DataWatch presents information on how these institutions are being affected by market changes. Although AHCs are not as successful as other hospitals are in attracting managed care patients, competitive pressures had not eroded AHCs' financial status as of 1994. However, increasing enrollment in managed care and potential changes in both Medicare and Medicaid suggest that pressure on the financing of these institutions' social missions will continue to grow over time.

Academic Medical Centers↗
PubMed2004

Effects of a stress-management program on injury and stress of competitive gymnasts.

20 competitive gymnasts (17 girls, 3 boys; mean age, 14.4 +/- 3.4 yr.) were recruited from two clubs in Auckland, New Zealand. Gymnasts, who had competed at a national or international level, were divided into two groups to examine the effects of a longitudinal stress-management program on injury and stress. Those in the stress-management group took part in 12 1-hr. sessions over 24 weeks, while the control group took part in a placebo program of anthropometric measurements and lectures on nutrition. All participants completed the Life Experiences Survey and Athletic Experiences Survey at baseline, 3 mo., 6 mo. (end of intervention), and 9 mo. (3 mo. after completion of intervention). Injury data were collected prospectively by weekly self-report over the 9-mo. study. Repeated-measures analyses of covariance with age and, where applicable, the baseline measure of the dependent variable entered as covariates, indicated no significant group or group by time effects for the scores on the two surveys, or injury scores. However, given the small sample, the statistical power of the study to detect even large effects was low. Therefore, rather than concluding that the stress-management program had no effect on training hours lost to injury or on stress, upper limits were placed on the magnitude of any effects that might exist. Further research using larger samples is recommended.

Adaptation, Psychological↗
PubMed1991

Competition versus planning in health care: implications for corporate and individual incentives, efficiency & control.

This paper is about the management of change; and, most especially, about the changing tides of thinking that health planning and, more latterly, competition could bring about desired change in the health industry towards cost containment, efficiency and control. Looking back over the decade of the 1980s, it was characterised, for many countries, as a real questioning of the role of the public sector in people's life, and--in terms of public/private provision--a re-examination of what is public and should be. Coupled with this inquiry was a growing belief that comprehensive health planning was too lofty a goal, and that however elegant in theory, its delivery in practice fell far short of its ideals. Attention has therefore focused on the workings of competitive markets, and the extent to which objectives of cost containment and economic efficiency can be better addressed through competition and internal markets. In reality, the mixed economy is the only policy option available to developed countries today. Public and private monopolies are frowned upon, and the search is on for intermediate possibilities that capture some of the advantages of markets without their disadvantages, and arrangements that motivate consumer choice and simultaneously yield efficiency in the production and distribution of health care. By way of illustration, this paper looks at a number of innovations taking place to address these issues; and, in the context of the UK, at the most recent government proposals in respect of self-governing trusts and GP budget holders, as illustrations of the move towards the internal market, or to managed competition. Not surprisingly, the two areas that feature large on the agenda are hospital (and community) information systems; and, the motivations, rewards and penalties of the provider institutions that deliver services, and the consumers and purchasers who will "buy" them. Whether the mould can and should be broken is left tantalisingly open in the concluding remarks, save that at the very least, it does require both political will and medical compliance.

Budgets↗
PubMed1986

Advocacy skills and strategies for patient education managers.

In an era of increasing competition for patient education resources, patient education managers need to employ effective advocacy skills in order for their programs to continue to grow. In order to identify the advocacy skills and strategies currently being used, a series of four invitational seminars were convened around the country to allow patient education managers to share the approaches they have found to be useful. This paper summarizes those skills and strategies which fall into three categories: general advocacy, preparation, and implementation.

Education Department, Hospital↗
PubMed1988

A management development program for middle level nurse managers.

In an economic-oriented, competitive health care environment, middle level nurse managers must now perform their roles with a higher level of managerial and leadership skills than previously required. A systematic, consistent approach to the development of nurse managers will assist them in meeting role responsibilities. The authors describe a management development program for middle level nurse managers. An orientation curriculum plan is presented and a framework for advanced management enhancements is illustrated.

Administrative Personnel↗