Rules of the Game: How Public Policy Affects Local Health Care Markets

Health Affairs

Volumn 17, Issue 4, 1998, Pages 140-148

  Solomon, Loel S ^a  

^a NONE

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; COMMUNITY CARE; HEALTH CARE COST; HEALTH CARE PERSONNEL; HEALTH CARE POLICY; HEALTH INSURANCE; HUMAN; LEGAL ASPECT; LONGITUDINAL STUDY; MEDICAID; MEDICARE; NON PROFIT ORGANIZATION; ORGANIZATION AND MANAGEMENT; POLICY; UNITED STATES;

COMMUNITY HEALTH SERVICES; HEALTH CARE REFORM; HEALTH CARE SECTOR; HEALTH PERSONNEL; HUMANS; LONGITUDINAL STUDIES; MANAGED CARE PROGRAMS; MEDICAID; MEDICARE; ORGANIZATIONS, NONPROFIT; PUBLIC POLICY; UNITED STATES;

EID: 0032112867     PISSN: 02782715     EISSN: None     Source Type: Journal    
DOI: 10.1377/hlthaff.17.4.140     Document Type: Article

References (28)

1. The design of the Community Tracking Study is described in P. Kemper et al., "The Design of the Community Tracking Study: A Longitudinal Study of Health System Change and Its Effect on People," Inquiry (Summer 1996): 195-206. The twelve metropolitan statistical areas that are part of the Community Tracking Study are Boston, Massachusetts; Cleveland, Ohio; Greenville, South Carolina; Indianapolis, Indiana; Lansing, Michigan; Little Rock, Arkansas; Miami, Florida; Newark, New Jersey; Orange County, California; Phoenix, Arizona; Seattle, Washington; and Syracuse, New York. For descriptions of the communities and site visit methods, see L. Kohn et al., eds., Health System Change in Twelve Communities (Washington: Center for Studying Health System Change, 1997).
2. The design of the Community Tracking Study is described in P. Kemper et al., "The Design of the Community Tracking Study: A Longitudinal Study of Health System Change and Its Effect on People," Inquiry (Summer 1996): 195-206. The twelve metropolitan statistical areas that are part of the Community Tracking Study are Boston, Massachusetts; Cleveland, Ohio; Greenville, South Carolina; Indianapolis, Indiana; Lansing, Michigan; Little Rock, Arkansas; Miami, Florida; Newark, New Jersey; Orange County, California; Phoenix, Arizona; Seattle, Washington; and Syracuse, New York. For descriptions of the communities and site visit methods, see L. Kohn et al., eds., Health System Change in Twelve Communities (Washington: Center for Studying Health System Change, 1997).
3. See, for instance, A. Katz and J. Thompson, "The Role of Public Policy in Health Care Market Change," Health Affairs (Summer 1996): 77-91; P. Starr, The Social Transformation of American Medicine (New York: Basic Books, 1982); and J. Robinson and H. Luft, "Competition, Regulation, and Hospital Costs: 1982 to 1986," Journal of the American Medical Association (11 June 1988): 2676-2682.
4. See, for instance, A. Katz and J. Thompson, "The Role of Public Policy in Health Care Market Change," Health Affairs (Summer 1996): 77-91; P. Starr, The Social Transformation of American Medicine (New York: Basic Books, 1982); and J. Robinson and H. Luft, "Competition, Regulation, and Hospital Costs: 1982 to 1986," Journal of the American Medical Association (11 June 1988): 2676-2682.
5. See, for instance, A. Katz and J. Thompson, "The Role of Public Policy in Health Care Market Change," Health Affairs (Summer 1996): 77-91; P. Starr, The Social Transformation of American Medicine (New York: Basic Books, 1982); and J. Robinson and H. Luft, "Competition, Regulation, and Hospital Costs: 1982 to 1986," Journal of the American Medical Association (11 June 1988): 2676-2682.
6. Katz and Thompson, "The Role of Public Policy in Health Care Market Change," 90; and P.B. Ginsburg, "The RWJF Community Snapshots Study: Introduction and Overview," Health Affairs (Summer 1996): 7-20.
7. Katz and Thompson, "The Role of Public Policy in Health Care Market Change," 90; and P.B. Ginsburg, "The RWJF Community Snapshots Study: Introduction and Overview," Health Affairs (Summer 1996): 7-20.
8. Indigent care policy and other policies relating specifically to care for the poor are discussed in detail in a Lewin Group paper: R. Feldman and R. Baxter, "The Impact of Health System Change on Traditional Providers of Care to the Poor" (forthcoming).
9. These programs implemented at the discretion of the states are distinguished here from early implementation of federally mandated increases in the federal poverty level for children and pregnant women who are categorically eligible for Medicaid.
10. R.J. Baxter and R.E. Mechanic, "The Status of Local Health Care Safety Nets," Health Affairs (July/August 1997): 7-23.
11. W.P. Welch, "Improving Medicare Payments to HMOs: Urban Core versus Suburban Ring," Inquiry (Spring 1989): 62-71.
12. Balanced Budget Act of 1997, H.R. 2015,105th Cong., 1st sess. (1997), sec. 5001.
13. "New Medicare HMO Rates: One Plan's Ceiling Is Another Plan's Floor," Medicine and Health, 15 September 1997, 1.
14. "Update: Any Willing Provider," State Health Notes, 3 April 1997, 3.
15. National Association of Insurance Commissioners, "Draft White Paper on State Regulation of Risk-Bearing Entities" (Washington; NAIC, December 1996).
16. Ty Pine, Ohio State Department of Insurance, personal communication, 16 September 1997.
17. A.B. 11330, sec. 4408, "Financial Requirements for Integrated Delivery Systems," New York State Department of Insurance (Undated draft).
18. Balanced Budget Act of 1997, H.R. 2015, sec. 5001.
19. Lewin Group, State Regulatory Experience with Provider Sponsored Organizations: Final Paper (Prepared for the U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, HHS Contract no. 100-93-0012, 11 June 1997), C-3.
20. Health Policy Tracking Service, Intergovernmental Health Policy Project, National Conference of State Legislatures, Washington, D.C., October 1996.
21. That reform followed a federal judge's ruling, later overturned, that the surcharge violated the Employee Retirement Income Security Act (ERISA). See J. Cantor, "Health Care Unreform: The New Jersey Approach," Journal of the American Medical Association (22/29 December 1993): 2968.
22. California Department of Justice, Office of the Attorney General, Review Protocol: Ownership or Control Transfers of Nonprofit Health Facilities (Corporations Code Sections 5914 et seq.) (Sacramento, undated); and Office of the Attorney General, Commonwealth of Massachusetts, For-Profit Conversions and Acquisition of Non-Profits: Attorney General Issues and Procedures (Boston, 30 October 1995).
23. California Department of Justice, Office of the Attorney General, Review Protocol: Ownership or Control Transfers of Nonprofit Health Facilities (Corporations Code Sections 5914 et seq.) (Sacramento, undated); and Office of the Attorney General, Commonwealth of Massachusetts, For-Profit Conversions and Acquisition of Non-Profits: Attorney General Issues and Procedures (Boston, 30 October 1995).
24. D. Shriber, "State Experience in Regulating a Changing Health Care System," Health Affairs (March/April 1997): 49-50.
25. S. 1288 (Arizona), enacted 7 April 1997; H. 1826 (Indiana), enacted 13 May 1997; H. 242 (Ohio), enacted 6 May 1997; S. 5227 (Washington), enacted 13 May 1997; and A.B. 3101 (California), enacted 30 September 1996.
26. J. Bell et al., "The Preservation of Charitable Health Care Assets," Health Affairs (March/April 1997): 126.
27. R. Tomsho, "Columbia/HCA Move into Michigan Blocked by Judge," Wall Street Journal 9 September 1996, B8.
28. Shriber, "State Experience in Regulating a Changing Health Care System," 63.