Provider selection, bargaining, and utilization management in managed care

Economic Inquiry

Volumn 40, Issue 3, 2002, Pages 348-365

  Lindrooth, Richard C ^a   Norton, Edward C ^b   Dickey, Barbara ^c  

^a NORTHWESTERN UNIVERSITY   (United States)

^b UNIVERSITY OF NORTH CAROLINA   (United States)

^c CAMBRIDGE HOSPITAL   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

EID: 0036665811     PISSN: 00952583     EISSN: None     Source Type: Journal    
DOI: 10.1093/ei/40.3.348     Document Type: Article

References (29)

1. Beinecke, R. H., D. S. Shepard, M. Goodman, and M. Rivera. "Assessment of the Massachusetts Managed Behavioral Health Program: Year 3." Administration and Policy in Mental Health, 24, 1997, 191-204.
2. Bond, G. R., L. D. Miller, R. D. Krumwied, and R. S. Ward. "Assertive Case Management in Three CMHCs: A Controlled Study." Hospital and Community Psychiatry, 39(4), 1988, 411-18.
3. Borland, A., J. McRae, and C. Lycan. "Outcomes of Five Years of Continuous Intensive Case Management." Hospital and Community Psychiatry, 40(4), 1989, 369-76.
4. Callahan, J. J., D. S. Shepard, R. H. Beinecke, M. J. Larson, and D. Cavanaugh. "Mental Health/Substance Abuse Treatment in Managed Care: The Massachusetts Medicaid Experience." Health Affairs, 14(3), 1995, 173-84.
5. Conrad, D., T. Wickizer, C. Maynard, T. Klastorin, D. Lessler, A. Ross, N. Soderstrom, S. Sullivan, J. Alexander, and K. Travis. "Managing Care, Incentives, and Information: An Exploratory Look into the 'Black Box' of Hospital Efficiency." Health Services Research, 31(3), 1996, 235-59.
6. Dickey, B., S. T. Normand, E. C. Norton, H. Azeni, W. Fisher, and F. Altaffer. "Managing the Care of Schizophrenia: Lessons from a Four-year Massachusetts Medicaid Study." Archives of General Psychiatry, 53(10), 1996, 945-52.
7. Ellis, R. P., and T. G. McGuire. "Hospital Response to Prospective Payment: Moral Hazard, Selection and Practice Style Effects." Journal of Health Economics, 15(3), 1996, 257-78.
8. Fisher, B., R. C. Lindrooth, E. C. Norton, and B. Dickey. "How Managed Care Organizations Develop Selective Contracting Networks: A Case Study from Massachusetts." Inquiry, 35(4), 1998, 417-31.
9. Frank, R. G., and T. G. McGuire. "Savings from a Medicaid Carve-out for Mental Health and Substance Abuse Services in Massachusetts." Psychiatric Services, 18(9), 1997, 1147-52.
10. Goldman, W., J. McCulloch, and R. Sturm. "Costs and Utilization of Mental Health Services before and after Managed Care." Health Affairs, 17(2), 1998, 40-52.
11. Gotowka, T. D., and R. B. Smith. "Focused Psychiatric Review: Impacts on Expense and Utilization." Benefits Quarterly, 7(4), 1991, 73-81.
12. Kerr, E. A., B. S. Mittman, R. D. Hays, A. L. Siu, B. Leake, and R. H. Brook. "Managed Care and Capitation in California: How Do Physicians at Financial Risk Control Their Own Utilization?" Annals of Internal Medicine, 123, 1995, 500-04.
13. Lindrooth, R. C. "Managed Care Organizations as Agents: Cost-Reducing Effort Versus Health Outcomes." IHSRPS Working Paper 00-07, 2000.
14. Ma, C. A., and T. G. McGuire. "Cost and Incentives in a Behavioral Health Carve-out." Health Affairs, 17, 1998a, 52-69.
15. _. "Network Incentives in Managed Health Care." Journal of Economics and Management Strategy, 11(1), 2002, 1-35.
16. Manning, W. G. "The Logged Dependent Variable, Heteroscedasticity, and the Retransformation Problem." Journal of Health Economics, 17, 1998, 283-95.
17. Newhouse, J. P. "Reimbursing Health Plans and Health Providers: Selection versus Efficiency in Production." Journal of Economic Literature, 34, 1996, 1236-63.
18. Pauly, M. "Market Power, Monopsony and Health Insurance Markets." Journal of Health Economics, 7(2), 1988, 111-28.
19. _. "Managed Care, Market Power and Monopsony." Health Services Research, 33(5), 1998, 1439-60.
20. Robinson, J. C. "HMO Market Penetration and Hospital Cost Inflation in California." Journal of the American Medical Association, 266(19), 1991, 2719-23.
21. _. "The Corporate Practice of Medicine: Competition and Innovation in Health Care." Berkeley: University of California Press, 1999.
22. Robinson, J. C., and C. S. Phibbs. "An Evaluation of Medicaid Selective Contracting in California." Journal of Health Economics, 8, 1989, 437-55.
23. Schlesinger, M., R. Dorwart, C. Hoover, and S. Epstein. "The Determinants of Dumping: A National Study of Economically Motivated Transfers Involving Mental Health Care." Health Services Research, 32(5), 1997, 561-90.
24. Sturm, R. "How Expensive Is Unlimited Mental Health Coverage?" Journal of the American Medical Association, 278(18), 1997, 1533-37.
25. Sturm, R., C. A. Jackson, L. S. Meredith, W. Yip, W. G. Manning, W. H. Rogers, and K. B. Wells. "Mental Health Care Utilization in Prepaid and Fee-for-Service Plans among Depressed Patients in the Medical Outcomes Study." Health Services Research, 30(2), 1995, 320-40.
26. Wickizer, T. M. "The Effect of Utilization Review on Hospital Use and Expenditures: A Review of the Literature and an Update on Recent Findings." Medical Care Review, 47(3), 1990, 327-36.
27. Wickizer, T. M., J. R. C. Wheeler, and P. J. Feldstein. "Does Utilization Review Reduce Unnecessary Hospital Care and Contain Costs?" Medical Care, 27(6), 1989, 632-47.
28. Zwanziger, J., G. A. Melnick, and A. Bamezai. "Costs and Price Competition in California Hospitals, 1980-1990." Health Affairs, 1994a, 118-26.
29. Zwanziger, J., G. A. Melnick, J. Mann, and L. Simonson. "How Hospitals Practice Cost Containment with Selective Contracting and the Medicare Prospective Payment System." Medical Care, 32(11), 1994b, 1153-62.