Narrow hospital networks have proliferated in health systems with managed care. We investigate the causal effect of network breadth on mortality leveraging the termination of the largest health insurer in Colombia. The termination caused a substantial increase in mortality accompanied by...

Improving global health outcomes amidst fiscal constraints, climate crises, and pandemics is a formidable challenge for governments worldwide. The recently published WHO/World Bank 2023 UHC Global Monitoring Report underscores a concerning reality: despite the goal of universal health coverage...

What is Integrated Care -- Refocussing Care What Does People Centredness Mean -- Evidence Supporting Integrated Care -- Values in Integrated Care -- Integrating Health and Social Care Systems -- Integrated Community Care A Community Drive -- Path Dependence and Integrated Care -- Values and...

Managed care activity may alter the incentives associated with the acquisition and use of new medical technologies, with potentially important implications for health care costs, patient care, and outcomes. This paper discusses mechanisms by which managed care could influence the adoption of new...

State governments contract with health maintenance organizations (HMOs) to coordinate medical care for nearly 20 million Medicaid recipients. Identifying the causal effect of HMO enrollment on government spending and health care quality is difficult if, as is often the case, recipients have the...

Over the last two decades, employers have increasingly offered workers a choice of health plans. The availability of choice has the potentially beneficial effects of lowering the cost and increasing the quality of health care through greater competition among health plans for enrollees as well...

During the 1990s US healthcare markets underwent a significant transformation. Managed care rose to become the dominant form of insurance in the private sector. Also, a wave of hospital consolidation occurred. In 1990, the mean population-weighted hospital Herfindahl-Hirschman Index (HHI) in a...

Managed care health insurers in the US restrict their enrollees' choice of hospitals to within specific networks. This paper considers the implications of these restrictions. A three-step econometric model is used to predict consumer preferences over health plans conditional on the hospitals...

Medicaid is increasingly provided by private managed care plans. I investigate the staggered rollout of mandates across counties in New York, which required Medicaid beneficiaries to enroll in a private managed care plan. I find improvements following the mandate, as evidenced by increased...

Grundideen von Managed Care -- Grundzüge des amerikanischen Gesundheitssystems -- Neue Institutionenökonomie -- Managed-Care-Organisationen und -Produkte -- Managed-Care-Instrumente -- Evaluation von Versorgungskonzepten.

Das Buch stellt die Vielzahl unterschiedlicher Managed-Care-Organisationsformen und -Instrumente vor. Dabei wird detailliert sowohl auf Organisationsformen wie HMOs, PPOs, ACOs, PBM und andere eingegangen, als auch auf im Rahmen von Managed Care entstandene Vertragsmodelle. Neben den...

Chapter 1 Healthcare Systems of the World -- Chapter 2 Future of Health Care Delivery -- Chapter 3 Epidemiological Perspective of HC Management -- Chapter 4 Health Policy & Planning -- Chapter 5 Health Care Finance -- Chapter 6 Evaluating Health Systems -- Chapter 7 Health Care Needs Assessment...

Gesundheitspolitik ist angesichts der vielfältigen Herausforderungen an das deutsche Gesundheitssystem in aller Munde. Es erscheint notwendig, diesen Diskurs unter anderem auch aus einer ökonomisch-volkswirtschaftlichen Perspektive zu führen. Hauptanliegen dieses Lehrbuches ist es, die dafür...

This insightful Research Handbook delivers a comprehensive analysis of the significant contemporary trends and issues affecting human resource management (HRM) for health care, and their subsequent impact on individuals, organisations and national health services.This title contains one or more...

Many observers have blamed HMOs for increasing financial pressures on private hospitals and causing them to cut back on the provision of charity care. We examine this issue using data on all hospital discharges in California between 1988 and 1996. We find that public hospitals in counties with...

Managed care may affect medical treatments for non-managed-care patients if it alters local market structure or physician behavior. We investigate whether higher levels of overall managed care market share are associated with greater use of recommended therapies for fee-for-service patients with...

The paper examines price discounting by health maintenance organizations and preferred provider organizations in markets for hospital services. Our empirical analysis focuses on transaction prices for angioplasty, which is a relatively common procedure, with well defined 'product'...

We use data on the enrollment decisions of federal annuitants to estimate the influence of publicizedratings on health plan choice. We focus on the impact of ratings disseminated by the NationalCommittee for Quality Assurance (NCQA), and use our estimates to calculate the value of...

This study examined the effects of education, income, and wealth on medical care expenditures in two Medicare managed care plans. The study also sought to elucidate the pathways through which socioeconomic status (SES) affects expenditures, including preferences for health and medical care and...

We investigate the effect of managed care on the health care system, focusing on the effects managed care could have on the number and types of health care providers and their efficiency. By influencing providers, managed care may change the structure and performance of the entire health care...

We extend our previous research by determining whether, and how, the impact of managed care on substance abuse treatment (SAT) services differs by facility ownership. We use the 2000 National Survey of Substance Abuse Treatment Services that contains data on service offerings and other...

It is generally assumed that managed care has been successful at capturing discounts from medical providers, but the implications have been a matter of debate. Critics argue that managed care organizations attain savings by reducing intensity of services, while others have argued that savings...

Many questions about technology growth and development in health care call for a broad-based characterization of technology availability. In this paper, we explore the possibility of producing aggregated estimates of technology availability by constructing an index of technology availability in...

Applying antitrust law to health care is a bit like reading poetry in translation. The words are all there, but the patterns and structure do not quite come across. Antitrust law envisions a world of buyers and sellers who trade goods or services for money in a market that should be as fair and...

Americans are experienced at fixing blame when things go wrong. Our political system lets us throw out the leaders whose lack of judgment, skill, or honesty seems to have been the cause. Our legal system lets us sue individuals or corporations perceived to have been at fault. Although it does...

There is considerable evidence that patients that are treated by high volume physicians and hospitals have better health outcomes than patients treated by low volume physicians and hospitals. Thus, as an indirect measure of quality differences between managed care and traditional fee-for-service...

We examine the recent increase in hospital advertising expenditures. We first illustrate that the rise in hospital advertising has not been universal. Large, not-for-profit, teaching hospitals have, by far, experienced the largest increase in spending. Adjusting for size, for-profit hospitals...

I describe several changes to Medicare in the 1990s, their rationale, and their likely effects. I focus principally on issues in the administered price systems Medicare uses to pay medical providers, especially those used for post-acute care providers, Health Maintenance Organizations (HMOs),...

Managed care health insurers in the US restrict their enrollees' choice of hospitals to specific networks. This paper investigates the causes and welfare effects of the observed hospital networks. A simple profit maximization model explains roughly 63 per cent of the observed contracts between...

We study the effect of physician incentives in an HMO network. Physician incentives are controversial because they may induce doctors to make treatment decisions that differ from those they would chose in the absence of incentives. We set out a theoretical framework for assessing the degree to...

We use data across states to examine the relation between HMO enrollment and medical spending. We find that increased managed care enrollment significantly reduces hospital cost growth. While some of this effect is offset by increased spending on physicians, we generally find a significant...

This paper is concerned with the economics of mental health. We argue that mental health economics is like health economics only more so: uncertainty and variation in treatments are greater; the assumption of patient self-interested behavior is more dubious; response to financial incentives such...

We seek to investigate whether managed health care can affect mortality, and if so, through which mechanisms. We estimate the impact of Medicare+Choice (M+C), Medicare's managed care program, on elderly mortality, using a county-level panel from 1993 to 2000. We control for endogenous M+C...

In this study, we examine the effects of Medicaid managed care (MMC) on prenatal care utilization and infant health. We obtain separate estimates of the effect of primary care case management (PCCM) managed care programs and HMO managed care plans on prenatal care utilization, birth weight, and...