How Physicians' Organizations Compete: Protectionism and Efficiency

Journal of Health Politics, Policy and Law

Volumn 29, Issue 1, 2004, Pages 75-105

  Page, Stephen ^a  

^a UNIVERSITY OF WASHINGTON   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

COMPETITION; HEALTH CARE COST; HEALTH CARE MANAGEMENT; HEALTH CARE ORGANIZATION; HEALTH CARE PLANNING; HEALTH CARE POLICY; HEALTH CARE QUALITY; HEALTH CARE SYSTEM; PRODUCTIVITY; REVIEW;

DELIVERY OF HEALTH CARE; GROUP PRACTICE; HOSPITAL-PHYSICIAN JOINT VENTURES; INDEPENDENT PRACTICE ASSOCIATIONS; PHYSICIAN'S ROLE;

EID: 1242296876     PISSN: 03616878     EISSN: None     Source Type: Journal    
DOI: 10.1215/03616878-29-1-75     Document Type: Review

References (76)

1. Alexander, J. A., T. Vaughn, L. R. Burns, H. S. Zuckerman, R. M. Andersen, P. Torrens, and D. W. Hilberman. 1996. Organizational Approaches to Integrated Health Care Delivery: A Taxonomic Analysis of Physician-Organization Arrangements. Medical Care Research and Review 53(1):71-93.
2. American Medical Association (AMA). 1999. Medical Groups in the U.S., 1999 Edition. Chicago: AMA.
3. Arnone, A. 2000. Building a Balanced Scorecard in Ambulatory Health Care. MPA Degree Project. Seattle: Evans School of Public Affairs, University of Washington.
4. Bailet Health Purchasing. 2002. Profiles of Organizations Using Quality Incentives. Washington, DC: National Health Care Purchasing Institute. Available through the National Health Care Purchasing Institute Web site at www.nhcpi.net/whatsnew.cfm.
5. Bazzoli, G. J., L. Dynan, and L. R. Burns. 1999/2000. Capitated Contracting of Integrated Health Provider Organizations. Inquiry 36(4):426-444.
6. Bazzoli, G. J., S. M. Shortell, N. Dubbs, C. Chan, and P. Kralovec. 1999. A Taxonomy of Health Networks and Systems. Health Services Research 33(6):1683-1717.
7. Bazzoli, G. J., R. Stein, J. A. Alexander, D. Conrad, S. Sofaer, and S. M. Shortell. 1997. Public-Private Collaboration in Health and Human Service Delivery: Evidence from Community Partnerships. Milbank Quarterly 75(4):533-561.
8. Becher, E. C., and M. Chassin. 2001. Improving the Quality of Health Care: Who Will Lead? Health Affairs 20(5):164-179.
9. Belkin, G. 1997. The Technocratic Wish: Making Sense and Finding Power in the "Managed" Medical Marketplace. Journal of Health Politics, Policy and Law 22:509-532.
10. Berenson, R. 1998. Bringing Collaboration into the Market Paradigm. Health Affairs 17(6):128-137.
11. Brewster, L., L. Jackson, and C. Lesser. 2000. Insolvency and Challenges of Regulating Providers That Bear Risk. Issue Brief No. 26. Washington, DC: Center for Health System Change.
12. Burns, J., and M. O'Kane. 1999. NCQA to Raise Level of Accountability among Health Plans. Insights and Outcomes. Fall. Available online at common.wcds.net/pdfs/iofall1999.pdf.
13. Burns, L. R. 1997. Physician Practice Management Companies. Health Care Management Review 22(4):32-46.
14. Burns, L. R., G. Bazzoli, L. Dynan, and D. R. Wholey. 2000. Impact of HMO Market Structure on Physician-Hospital Strategic Alliances. Health Services Research 35(1, pt. 1):101-132.
15. Burns, L. R., and M. Pauly. 2002. Integrated Delivery Networks: A Detour on the Road to Integrated Health Care? Health Affairs 21(4):128-143.
16. Burns, L. R., and D. P. Thorpe. 1993. Trends and Models in Physician-Hospital Organization. Health Care Management Review 18(4):7-20.
17. Casalino, L. 2001. Canaries in a Coal Mine: California Physician Groups and Competition. Health Affairs 20(4):97-108.
18. Center for Studying Health System Change. 1999. How Physician Organizations Are Responding to Managed Care. Issue Brief no. 20. Available online at www.hschange.com/CONTENT/61/.
19. Chassin, M. 2002. Achieving and Sustaining Improved Quality. Health Affairs 21(4):40-51.
20. Chow, C. W., D. Ganulin, K. Haddad, and J. Williamson. 1998. The Balanced Scorecard: A Potent Tool for Energizing and Focusing Healthcare Organization Management. Journal of Healthcare Management 43(3):263-280.
21. Conrad, D. 1999. Risk-Bearing Arrangements and Capital Financing Strategies for Integrated Health Systems. Quarterly Review of Economics and Finance 39:445-464.
22. Coye, M. J. 2001. No Toyotas in Health Care. Health Affairs 20(6):44-56.
23. Devers, K. 2002. Quality Improvement by Providers. Health Affairs 21(5):201-209.
24. Draper, D., R. Hurley, C. Lesser, and B. Strunk. 2002. The Changing Face of Managed Care. Health Affairs 21(1):11-23.
25. Dynan, L., G. Bazzoli, and L. R. Burns. 1998. Assessing the Extent of Integration Achieved through Physician-Hospital Arrangements. Journal of Health Care Management 43(3):242-262.
26. Eliasberg, E. 2000. Telephone interview with attorney with the U.S. Department of Justice, Antitrust Division, 31 March.
27. Enthoven, A., and S. Singer. 1999. Unrealistic Expectations Born of Defective Institutions. Journal of Health Policy, Politics and Law 24:931-940.
28. Felt-Lisk, S., and G. Mays. 2002. Back to the Drawing Board: New Directions in Health Plans' Care Management Strategies. Health Affairs 21(5):210-217.
29. Freeman, R., and J. Medoff. 1984. What Do Unions Do? New York: Basic Books.
30. Freudenheim, M. 2000. Buyers' Clubs for Medical Services Crop Up. New York Times, 25 August, A1.
31. -. 2001. Five Minnesota Health Insurers to Standardize Treatments. New York Times, 13 March, A1.
32. Greaney, T. L. 1999. Antitrust and the Healthcare Industry. Journal of Health Law 32(3):391-416.
33. Grossman, J. 2000. Health Plan Competition in Local Markets. Health Services Research 35(1, pt. 1):17-35.
34. Grumbach, K., J. Coffman, K. Vranizan, N. Blick, and E. O'Neil. 1998. Independent Practice Association Physician Groups in California. Health Affairs 17(3):227-237.
35. Guadagnino, C. 2000. MD Joint Negotiation Bills Advance. Physicians' News Digest, April. Available online at www.physiciansnews.com/cover/400.html.
36. -. 2002. NJ Passes Physician Joint Negotiation Law. Physicians' News Digest, March. Available online at www.physiciansnews.com/spotlight/302.html.
37. Haas-Wilson, D., and M. Gaynor. 1998. Physician Networks and Their Implications for Competition in Health Care Markets. Health Economics 7(2):179-182.
38. Hargraves, J. L., and S. Trude. 2002. Obstacles to Employers' Pursuit of Health Care Quality. Health Affairs 21(5):194-200.
39. Hirschman, A. 1970. Exit, Voice, and Loyalty. Cambridge: Harvard University Press.
40. Horoschak, M. 1996. Antitrust Guidance for Health Care Providers Enters a New Phase. Antitrust 11:28-32.
41. Hurley, R., J. Grossman, T. Lake, and L. Casalino. 2002. A Longitudinal Perspective on Health Plan-Provider Risk Contracting. Health Affairs 21(4):144-153.
42. Kaplan, R., and D. Norton. 1992. The Balanced Scorecard-Measures That Drive Performance. Harvard Business Review 70(1):71-79.
43. Kletke, P. R., D. W. Emmons, and K. D. Gillis. 1996. Current Trends in Physician Practice Arrangements: From Owners to Employees. Journal of the American Medical Association 276(7):555-560.
44. Kralewski, J., A. de Vries, B. Dowd, and S. Potthoff. 1995. The Development of Integrated Service Networks in Minnesota. Health Care Management Review 20(4):42-56.
45. Kralewski, J., T. Wingert, D. Knutson, C. Johnson, and P. Veazie. 1996. The Effects of Capitation Payment on the Organizational Structure of Medical Group Practices. Journal of Ambulatory Care Management 19(1):1-16.
46. Landon, B. E., I. B. Wilson, and P. D. Cleary. 1998. A Conceptual Model of the Effects of Health Care Organizations on the Quality of Medical Care. Journal of the American Medical Association 279(17):1377-1382.
47. Lesser, C., and P. Ginsburg. 2000. Update on the Nation's Health Care System: 1997-1999. Health Affairs 19(6):206-216.
48. Lyons, L., and A. Vivenzio. 1998. Employee Involvement in Seattle. Public Personnel Management 27(1):93-101.
49. McCubbins, M., and T. Schwartz. 1984. Congressional Oversight Overlooked: Police Patrols Versus Fire Alarms. American Journal of Political Science 2(1):165-179.
50. McLaughlin, C. P., T. R. Konrad, and D. E. Pathman. 1997. Maintaining the New Practice Networks. Health Care Management Review 22(4):19-31.
51. Medical Group Management Association. 2001. Performance and Practices of Successful Medical Groups Survey: 2001 Report Based on 2000 Data. Englewood, CO: Medical Group Management Association.
52. Moreland, J. 2000. Telephone interview with attorney with the U.S. Federal Trade Commission, Bureau of Competition, 30 March.
53. Morrissey, M. A., J. A. Alexander, L. R. Burns, and V. Johnson. 1996. Managed Care and Physician/Hospital Integration. Health Affairs 15(4):62-73.
54. Noble, A., and T. Brennan. 1999. The Stages of Managed Care Regulation: Developing Better Rules. Journal of Health Politics, Policy and Law 24:1275-1305.
55. Oswald, N. 2002. Structured Collaboratives: Accelerating Quality Improvement in California. Oakland, CA: California HealthCare Foundation.
56. Page, L. 2001. Group of Traditional Medical Practices Bucks HMO Trend. American Medical News, 15 January, 2.
57. Page, S. 2003. "Virtual" Health Care Organizations and the Challenges of Improving Quality. Health Care Management Review 28(1):79-92.
58. Penner, M. 1997. Capitation in California. Chicago: Health Administration Press.
59. Poznick, J. 2000. Telephone interview with representative of Physicians for Responsible Negotiation, 17 March.
60. Reed, M. C., A. K. Vratil, J. Stoddard, and J. L. Hargraves. 2001. Managed Care, Professional Autonomy, and Income: Effects on Physician Career Satisfaction. Journal of General Internal Medicine 16(10):675-684.
61. Robinson, J. C. 1998a. Consolidation of Medical Groups into Physician Practice Management Organizations. Journal of the American Medical Association 279(2):144-149.
62. -. 1998b. Financial Capital and Intellectual Capital in Physician Practice Management. Health Affairs 17(4):53-74.
63. -. 1999. The Corporate Practice of Medicine. Berkeley: University of California Press.
64. -. 2001. Physician Organization in California: Crisis and Opportunity. Health Affairs 20(4):81-96.
65. Rogers, J., and C. Sabel. 1993. Imagining Unions. Boston Review 18(5):10-12.
66. Sabel, C. 1994. Learning by Monitoring. In Handbook of Economic Sociology, ed. N. Smelser and R. Swedberg. Princeton, NJ: Princeton University Press.
67. Sage, W. M. 1999. Regulating through Information. Columbia Law Review 99(7):1701-1829.
68. Scheffler, R. 1996. Life in the Kaleidoscope: The Impact of Managed Care on the U.S. Health Care Workforce and New Model for the Delivery of Primary Care. In Primary Care: America's Health in a New Era, ed. M. C. Donaldson, R. D. Yordy, K. N. Lohr, and N. A. Vanselow. Washington, DC: National Academy Press.
69. -. 1999. Physician Collective Bargaining: A Turning Point in U.S. Medicine. Journal of Health Politics, Policy and Law 24:1071-1076.
70. Shenkin, B. 1995. The Independent Practice Association in Theory and Practice. Journal of the American Medical Association 273(24):1937-1942.
71. Shortell, S. M., A. P. Zukoski, J. A. Alexander, G. J. Bazzoli, D. Conrad, R. Hasnain-Wynia, S. Sofaer, B. Y. Chan, E. Casey, and F. S. Margolin. 2002. Evaluating Partnerships for Community Health Improvement: Tracking the Footprints. Journal of Health Politics, Policy and Law 27:49-91.
72. Simon, C., and P. Born. 1996. Physician Earnings in a Changing Managed Care Environment. Health Affairs 15(3):124-133.
73. Strunk, B., K. Devers, and R. Hurley. 2001. Health Plan-Provider Showdowns on the Rise. Issue Brief no. 40. Washington, DC: Center for Studying Health System Change.
74. Thompson, J. W., J. Bost, F. Ahmed, C. E. Ingalls, and C. Sennett. 1998. The NCQA's Quality Compass: Evaluating Managed Care in the United States. Health Affairs 17(1):152-158.
75. U.S. Department of Labor. 1996. Working Together for Public Service: Report of the U.S. Secretary of Labor's Task Force on Excellence in State and Local Government through Labor-Management Cooperation. Washington, DC: U.S. Department of Labor.
76. Weiner, B. J., J. A. Alexander, and H. S. Zuckerman. 2000. Strategies for Effective Management Participation in Community Health Partnerships. Health Care Management Review 25(3):48-66.