Integrated health care, capitated payment, and quality: The role of regulation

Annals of Internal Medicine

Volumn 124, Issue 4, 1996, Pages 442-448

  Swartz, Katherine ^a   Brennan, Troyen A ^a  

^a HARVARD SCHOOL OF PUBLIC HEALTH   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

HEALTH CARE COST; HEALTH CARE POLICY; HEALTH CARE QUALITY; HEALTH INSURANCE; HEALTH MAINTENANCE ORGANIZATION; LAW; MEDICAL ETHICS; PRIORITY JOURNAL; REVIEW;

EID: 0030040186     PISSN: 00034819     EISSN: None     Source Type: Journal    
DOI: 10.7326/0003-4819-124-4-199602150-00009     Document Type: Review

References (47)

1. Relman AS. Practicing medicine in the new business climate [Editorial] N Engl J Med 1987,316 1150-1.
2. Rodwin MA. Medicine, Money and Morals Physician's Conflicts of Interest New York Oxford Univ Pr, 1993
3. Clark R. Does the non-profit form fit the hospital industry? Harvard Law Review 1980 93, 1416-80
4. Angell M. The doctor as double agent Kennedy Institute of Ethics Journal 1993,3 279-86
5. Morreim EH. Balancing Act The New Medical Ethics of Medicine's New Economics Boston. Kluwer, 1991
6. Hillman AL. Financial incentives for physicians m HMOs. Is there a conflict of interest? N Engl J Med 1987;317 1743-8
7. La Puma J, Schiedermayer DL The ethics of managed care in managed competition In Nash D, ed Managed Care. A Survival Guide for the 1990s, 1993
8. Ethical issues in managed care Council on Ethical and Judicial Affairs, American Medical Association JAMA 1996,273-330-5
9. Emanuel EJ, Dubler NN. Preserving the physician-patient relationship in the era of managed care JAMA 1995;273 323-9
10. Clancy CM, Brody H. Managed care Jekyll or Hyde? [Editorial] JAMA 1995,273-338-9
11. Iglehart JK. The struggle between managed care and fee-for-servicc practice N Engl J Med. 1994,331:63-7
12. Kassirer JP. Managed care and the morality of the marketplace [Editorial] N Engl J Med 1995,333 50-2
13. Shortell SM, Gillies RR, Anderson DA. The new world of managed care creating organized delivery systems Health Aff (Millwood) 1994, 1346-64.
14. 42 U S.C A, §300 E-10
15. Weiner JP, de Lissovoy G. Razing a Tower of Babel a taxonomy for managed care and health insurance plans J Health Polit Policy Law 1993, 18 75-103
16. Welch WP, Hillman AL, Pauly MV. Toward new typologies for HMO's Milbank Q 1990,68 221-43.
17. Hall MA. Managed competition and integrated health care systems. Wake Forest Law Review 1994,24 1-18
18. Corcoran JD. Integrated delivery systems reposition for reform NGMJ July/August 1993, 15
19. Philbin PW. From the ground up• planting the seeds of network development Hospitals and Health Network 5 Jun, 1993
20. Mick SS, Conrad DA. The decision to integrate vertically in health care organizations Hosp Health Serv Adm 1988,33 345-60.
21. Costolitz J. All together now National Journal 1993,25:2704
22. Burns LR, Thorpe DP. Trends and models in physician-hospital organization Health Care Manage Rev 1993,18:7-20
23. Johnsson J. Medical centers lose power in Twin Cities market shift American Medical Association Medical News 1994,May 2 1
24. Hillman AL, Pauly MV, Kerstein JJ. How do financial incentives affect physicians' clinical decisions and the financial performance of health maintenance organizations? N Engl J Med 1989,321.86-92.
25. Udvarhelyi IS, Jennison K, Phillips RS, Epstein AM. Comparison of the quality of ambulatory care for fee-for-service and prepaid patients Ann Intern Med 1991,115 394-400
26. Newhouse JP. Free for All? Lessons from the Rand Health Insurance Experiment Cambridge, MA Harvard Univ Pr, 1993
27. Miller RH, Luft HS. Managed care plan performance since 1980 A literature analysis. JAMA 1994,271 1512-9
28. Emanuel EJ, Brett AS. Managed competition and the patient-physician relationship N Engl J Med 1993,329 879-82
29. Annotated Code of Maryland, §19-705 1 (1993)
30. 10 California Statutes Annotated, §1350, 10 California Code of Regulations, § 1300 80 Medical Survey Procedures
31. Johnsson J. Dad's protest leads to record fine against California HMO American Medical News 1994;12 December.36
32. Texas Statutes Article 20A 13 (a) (d).
33. Texas Statutes Article 20A 14
34. Brennan TA, Berwick DM. Regulating for Improvement. Government, Markets, and the Quality of American Health Care San Francisco Jossey-Bass, 1995.
35. Texas Administrative Code Tit 28, Section 3 3 703 (1994).
36. Texas Administrative Code Tit 28, Section 3.3 704 (1994)
37. Chirba-Martin MA, Brennan TA. The critical role of ERSSA in state health reform Health Aff (Millwood). 1994,13 142-56.
38. H R. 4527, 103rd Cong , 2d sess (1994); S 2196, 103rd Cong, 2d sess (1994).
39. Higgins DB. IRS and HHS on integrated delivery new rules or just talk? Health Law Reporter. 1993;2:586-7.
40. Department of Health and Human Services, Office of the Inspector General. Health care programs fraud and abuse, civil money penalties for physician incentive plans Federal Register 1994;53:4601
41. Meyer H. Quality problems could spell trouble for Medicaid HMOs. American Medical News 1995,23/30 Jan 9
42. Zablocki E. Is accreditation in your future? HMO Magazine. 1992;July/Au-gust-48-52
43. National Committee for Quality Assurance. Health Plan Employer Data and Information Set and User's Manual Version 2.0 5 May 1993
44. HEDIS Sets the Stage for Health Plan Report Cards. USQA Quality Monitor: The Journal of Health Care Performance Measurement and Improvement 1994.1 8-9.
45. Epstein A. Performance reports on quality - prototypes, problems, and prospects N Engl J Med. 1995,333:57-61
46. Sharrott D. Provider's specific quality of care data: a proposal for limited mandatory disclosure Brooklyn Law Review 1992,58:85-121.
47. Hannan EL, Kilburn H Jr, Racz M, Shields E, Chassin MR. Improving the outcomes of coronary bypass surgery in New York State JAMA 1994;271.761-6.