Competition and quality among managed care plans in the USA

International Journal for Quality in Health Care

Volumn 10, Issue 5, 1998, Pages 411-419

  Davidson, Stephen M ^a   Restuccia, Joseph D ^a  

^a BOSTON UNIVERSITY   (United States)

Author keywords

Competition; HMOs; Managed care; Quality

Indexed keywords

COMPETITION; EVIDENCE BASED MEDICINE; HEALTH INSURANCE; HEALTH MAINTENANCE ORGANIZATION; MANAGED CARE; PRACTICE GUIDELINE; PRIORITY JOURNAL; QUALITY CONTROL; REVIEW; UNITED STATES;

CONSUMER SATISFACTION; ECONOMIC COMPETITION; HEALTH BENEFIT PLANS, EMPLOYEE; HEALTH CARE REFORM; HEALTH CARE SECTOR; HUMANS; MANAGED CARE PROGRAMS; QUALITY ASSURANCE, HEALTH CARE; UNITED STATES;

EID: 0031782592     PISSN: 13534505     EISSN: None     Source Type: Journal    
DOI: 10.1093/intqhc/10.5.411     Document Type: Review

References (36)

1. The President's Health Security Plan. New York: Times Books, 1993.
2. Enthoven AC. The history and principles of managed competition. Health Affairs 1993; 12 (suppl.): 24-48.
3. Jensen GA, Morrisey MA, Gaffney S, Liston DK. The new dominance of managed care: insurance trends in the 1990s. Health Affairs 1997; 16(1): 125-136.
4. Welch WP, Hillman AL, Pauly MV. Toward new topologies for HMOs. Milbank Quart 1990; 68: 221-243.
5. 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.
6. Davidson SM. What the states should expect from managed care and why. In SM Davidson, SA Somers, eds. Remaking Medicaid Managed Care and the Public Good. San Francisco: Jossey-Bass Publishing Co., 1998: 181-196.
7. Miller RH, Luft HS. Does managed care lead to better or worse quality of care? Health Affairs 1997; 16(5): 7-25.
8. Miller RH, Luft HS. Managed care plan performance since 1980: A literature analysis. J Am Med Assoc 1994; 271: 1512-1529.
9. Smith A. An Inquiry into the Nature and Causes of the Wealth of Nations. New York: The Modern Library, 1937: 423.
10. Stiglitz JE. Economics, 2nd edn. New York: WW Norton & Co., 1997.
11. Evans RG. Going for the gold: the redistributive agenda behind market-based health care reform. J Health Polit Policy Law 1997; 22: 427-465.
12. Rice T. Can markets give us the health system we want? J Health Polit Policy Law 1997; 22: 383-425.
13. Cooper PF, Schone BS. More offers, fewer takers for employment-based health insurance: 1987 and 1996. Health Affairs 1997; 16(6): 142-149.
14. Maxwell J, Briscoe F, Davidson S et al. Managed competition in practice: 'value purchasing' by fourteen employers. Health Affairs 1998; 17(3): 216-226.
15. Bard MR. Purchasing health care and value. Workforce 1998; 77: 92-99.
16. Maxwell J, Briscoe F, Davidson S et al. Corporate Approaches to Implementing Managed Competition: Final Report to the Robert Wood Johnson Foundation. Boston: JSI Research and Training Institute, 1997.
17. Bailit MH. Ominous signs and portents: a purchaser's view of health care market trends. Health Affairs 1997; 16(6): 85-88.
18. Hunt KA, Singer SA, Gabel J et al. Paying more twice: when employers subsidize higher-cost health plans. Health Affairs 1997; 16(6): 150-156.
19. Gabel JR, Ginsburg PB, Hunt KA. Small employers and their health benefits, 1988-1996: an awkward adolescence. Health Affairs 1997; 16(5): 103-110.
20. Liu C-F, Christianson JB. The demand for health insurance by employees in a voluntary small group insurance program. Med Care 1998; 36: 437-443.
21. Christianson JB, Dowd B, Kralewski J, Hayes S, Wisner C. Managed care in the twin cities: what can we learn? Health Affairs 1995; 14(2): 114-130.
22. Hurst JW. Reform of health care in Germany. Health Care Financ Rev 1991; 12: 73-86.
23. Anderson OW. The Health Services Continuum in Democratic States. Ann Arbor, MI: Health Administration Press, 1989.
24. Marmor TR, Oberlander J. Rethinking Medicare reform. Health Affairs 1998; 17(1): 52-68.
25. Luft HS. Potential methods to reduce risk selection and its effects. Inquiry 1995; 32: 23-32.
26. Donabedian A. The Definition of Quality and Approaches to its Assessment. Ann Arbor, MI: Health Administration Press, 1980: 4.
27. National Committee for Quality Assurance. The State of Managed Care Quality. Available on the internet at http://www.ncqa.org
28. For information, consult the internet at http:/www.facct.org
29. Massachusetts Healthcare Purchaser Group. Cost/Quality Challenge. Boston, MA. March 1996.
30. Gold MR, Hurley R, Lake T et al. N Engl J Med 1995; 333: 1678-1683.
31. Davidson SM, Swartz K, Maxwell JH et al. Changes in the Florida Health Care System. Final report submitted to the Florida Agency for Health Care Administration by John Snow, Inc., Boston, MA, July 1997.
32. Peterson E, Shatin D, McCarthy D. Health Services Research at United HealthCare Corporation: The Role of the Center for Health Care Policy and Evaluation. Med Care Research Rev 1996; 53 (suppl.): S65-S76.
33. Murray J, Hanchak N, Schlackman N. Health Services Research at U.S. Quality Algorithms, Inc. Med Care Research Rev 1996; 53 (suppl.): S104-S117.
34. Gazmararian J, Lewis N. Health Services Research in the Prudential Health Care System. Med Care Research Rev 1996; 53: (suppl.) S82-S91.
35. Lawrence D. Quality lessons for public policy: a health plan's view. Health Affairs 1997; 16(3): 72-76.
36. Davidson SM, McCollom M, Heineke J. The Physician-Manager Alliance: Building the Healtly Health Care Organisation. San Francisco: Jossey-Bass Inc., 1996: 120-121.