Half-evolved managed care markets may be worst kind, survey finds.
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Economic Competition↗
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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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Developing an RFP for outsourcing investment management.
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Competitive Bidding↗
Are you ready to work in a managed care-dominated environment?
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California↗
The customer satisfaction dilemma facing managed care organizations.
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Economic Competition↗
Documenting and reporting cost savings.
As the health care industry continues to evolve toward a more competitive model, materials managers are increasingly expected to contribute to hospital profitability. One way to ensure that their contributions are recognized by administration is to formalize the process by which cost savings are reported.
Cost Control↗
The Chrysler experience, and forecasts.
Using his experience with Chrysler Motors as an example, the author tells how waste, inefficiency, and greed shaped a corporate health care system that, if it continued, could have blocked the corporation's recovery. An intense investigation of the use and abuse of this plan resulted in savings of about $100 million over an initial two-year period, with an additional $250 million savings projected over the following five years. In considering future changes in the country's health care system, he comments on the need for hospital cutbacks; reduction in unwarranted variations in medical practice; dissemination of necessary information to both individual and corporate purchasers of health care; increasing utilization of nurses in the medical arts; changes in the medical malpractice system; an increase in corporation case management systems; and competition among providers, which, by reducing costs, will most likely result in an efficient health care system for all people.
Cost Control↗
HMO update. Where are they headed?
Health maintenance organizations (HMOs) are undergoing major changes, among them the following: Enrollee growth will continue to be strong, although the rate of growth will diminish. HMOs will develop new product lines, such as offering preferred provider organizations and various cost management services. The competitive environment has become tougher. Quality of care concerns among the public are on the rise. Employers, while generally supportive of HMOs, are also questioning and changing their contractual relationships with them.
Economic Competition↗
The troubled HMO industry: what's next?
The fortunes of health maintenance organizations (HMOs) have been on a roller coaster ride for the last 15 years. Growth rates in the number and total enrollments of HMOs surged in 1973 and 1974 following passage of the federal HMO Act. Growth rates abated over the next 8 years. Several favorable factors converged in 1983 to push growth rates back up. Some 15 for-profit HMO companies went public with initial stock offerings during the 1983-85 period. Their stock prices soared as they compiled astounding records of enrollment, revenue and profit growth. In the next 2 years, however, stock prices dropped as quickly as they had risen. Intense price competition and inexperienced managers were important factors contributing to sharp descents in HMO earnings in 1986 and 1987. Some analysts now see positive signs pointing to an industry recovery. However, investors are not convinced of this as HMO stock prices remain severely depressed.
Data Collection↗
[Uncertainty, relations with agencies and asymmetric information (III)].
In this the third part of the article on uncertainty, agent relationships and asymmetrical information, Doctor Lara passes through Reykiavik and London on her to her final description in Seville. She takes advantage of this analogy to conceptualize the problem of principal and agent, analyzing generic agency relationships pertaining directly with health organizations. When dealing with the interesting question if the problem of principal and agent in health organizations can be lessened, a few equally interesting answers were formulated: allow the professionals to assume the mission and the values of the organization; a well thought out leadership policy; and improvement in information provided; an incentive policy; compatibility of interests between the principal and the agent; ethics and competitive advantage; quality management....
Decision Making, Organizational↗
Can database marketing rescue health plans?
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Cost Control↗
Toward Routine Automatic Pathway Discovery from On-line Scientific Text Abstracts.
We are entering a new era of research where the latest scientific discoveries are often first reported online and are readily accessible by scientists worldwide. This rapid electronic dissemination of research breakthroughs has greatly accelerated the current pace in genomics and proteomics research. The race to the discovery of a gene or a drug has now become increasingly dependent on how quickly a scientist can scan through voluminous amount of information available online to construct the relevant picture (such as protein-protein interaction pathways) as it takes shape amongst the rapidly expanding pool of globally accessible biological data (e.g. GENBANK) and scientific literature (e.g. MEDLINE). We describe a prototype system for automatic pathway discovery from on-line text abstracts, combining technologies that (1) retrieve research abstracts from online sources, (2) extract relevant information from the free texts, and (3) present the extracted information graphically and intuitively. Our work demonstrates that this framework allows us to routinely scan online scientific literature for automatic discovery of knowledge, giving modern scientists the necessary competitive edge in managing the information explosion in this electronic age.
Journal Article↗
Transforming an industrial giant. Interview by Thomas A. Stewart and Louise O'Brien.
In his 12 years at the helm of Siemens, CEO Heinrich von Pierer designed and directed a major transformation. Taking this German icon from a technically superb but slow-moving industrial giantto a disciplined yet nimble multinational has posed enormous challenges. Since 1992, Siemens has revamped its portfolio of businesses, expanded its reach into 192 countries, and created a more local-market-driven culture, gaining recognition as one of the best-managed and most competitive companies in the world. In this edited interview with HBR editor Thomas A. Stewart and consulting editor Louise O'Brien, von Pierer describes the requirements for transformation and culture change and how he broke down historical barriers at Siemens. He shares his insights about portfolio restructuring, his lessons from competing with GE, and the pros and cons of being based in Europe versus America. He reflects on the true start of globalization after the fall of the Berlin wall and on how dramatically the company needed to change in order to counter the resulting pricing pressures across all of its businesses. He talks, too, about the biggest challenge on his successor's desk-"the particular challenge of China;" he says. Amid all these topics, von Pierer reiterates the importance of people: "We all talk about people as our most important resource, but as a matter of fact, who's really taking care of people?... We need [their] backing. We can't afford to run into a situation where people no longer accept what we do."
Administrative Personnel↗
Development of a competitor DNA template of the 38 kDa gene for molecular quantification of M. tuberculosis.
The molecular quantification of Mycobacterium tuberculosis (TB) from clinical samples can improve the management of TB. Competitive polymerase chain reaction (C-PCR) is an accepted technique often used for this purpose, and IS6110 is the most popular target in such studies. As the number of these elements varies from 0 to 16 in clinical isolates, it is prone to give inconsistent results. A simple PCR-based approach is described in this study to generate a novel competitor for a single copy 38 kDa gene for the development of C-PCR for the quantification of the M. tuberculosis genome.
Adolescent↗
Rehabilitation after posterolateral dislocation of the elbow in a collegiate football player: a case report.
OBJECTIVE: To describe a functional rehabilitation program for a football player with a grade 2 posterolateral elbow dislocation to facilitate early return to competition. BACKGROUND: Conservative management of a posterior dislocation of the elbow is common. The elbow is the second most frequently dislocated large joint in adults. Two common mechanisms of dislocation are hyperextension and posterolateral rotation. Prolonged immobilization can be detrimental to regaining full range of motion and function of the elbow, whereas early directed rehabilitation may lead to early return to normal function. DIFFERENTIAL DIAGNOSIS: Elbow dislocation with medial collateral ligament rupture, elbow subluxation, elbow dislocation with neurovascular compromise, or supracondylar fracture. TREATMENT: The athlete received immediate care of reduction and immobilization in a 90 degrees posterior splint followed by a radiologic evaluation. Postreduction treatment included a short immobilization period and early initiation of protected active and resistive range-of-motion exercises. The athlete was able to return to full football activities in 3 weeks. He competed for the rest of the season with the elbow braced and taped, with no recurring incidents of instability. UNIQUENESS: The time to return to full participation was rapid. The medial collateral ligament was intact, as determined by magnetic resonance imaging. The athlete has since been followed for 2 football seasons and has not demonstrated any detrimental effects due to his early return. CONCLUSIONS: Early determination of the status of the medial collateral ligament through physical examination or imaging combined with early directed rehabilitation of a posterolateral elbow instability enabled this athlete to respond well. He regained pain-free full range of motion, strength, and function, allowing full participation in football at the Division I level with no recurring incidence of dislocation.
Journal Article↗
Personal incentives for exercise and body esteem: a canonical correlation analysis.
Two hundred twelve women and 93 men enrolled in physical education courses were administered the Personal Incentives for Exercise Questionnaire and the Body Esteem Scale. Canonical correlation was conducted. For women, it was determined that personal incentives for exercise have modest predictive power for the weight concern and physical conditioning dimensions of body esteem and very little predictive power for the sexual attractiveness dimension; the body esteem variates have slight predictive power for the competition and weight management dimensions of investment in exercise. For men, it was determined that personal incentives for exercise have modest predictive power for the physical conditioning dimension of body esteem, slight predictive power for physical attractiveness, and none for upper body strength; the body esteem variate has modest predictive power for the weight management dimension of incentives for exercise and slight predictive power for appearance and affiliation.
Adult↗
Ethics.
A first ethical question is whether the assumptions underlying managed care and competition are sound enough to justify the moral risks attendant on dividing the physician's loyalties. Physicians have been immune from liability if they respond to cost-containment directives in the same way as their colleagues.
Disclosure↗
Whither academic health centers? A commentary.
Academic health centers (AHCs) currently face the greatest challenge of their entire existence. Managed care, increased competition for research funding, and inefficiency all contribute to the present vulnerability of AHCs in the cost competitiveness of today's health care marketplace. The increased reliance of medical schools on clinical income to subsidize undergraduate and graduate education and biomedical research now jeopardizes the success of their missions, since clinical income is declining. While AHCs must make significant changes to adapt to the new environment, left on their own in the marketplace, many will not survive. Additionally, the biomedical research advances and high technology medical care that we have come to expect in this country will also likely suffer. A national approach designed to preserve responsive AHCs is needed.
Academic Medical Centers↗