Unhealthy competition: Consequences of health plan choice in California medicaid

American Journal of Public Health

Volumn 100, Issue 11, 2010, Pages 2235-2240

  Millett, Christopher ^a   Chattopadhyay, Arpita ^b   Bindman, Andrew B ^b  

^a San Francisco General Hospital   (United Kingdom)

^b UNIVERSITY OF CALIFORNIA   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADOLESCENT; ADULT; AGE; AMBULATORY CARE; ARTICLE; CHILD; DECISION MAKING; FEMALE; HEALTH CARE QUALITY; HEALTH INSURANCE; HOSPITALIZATION; HUMAN; INFANT; MALE; MEDICAID; MIDDLE AGED; ORGANIZATION AND MANAGEMENT; OUTCOME ASSESSMENT; POISSON DISTRIBUTION; PRESCHOOL CHILD; SEX DIFFERENCE; STATISTICS; TIME; UNITED STATES;

ADOLESCENT; ADULT; AGE FACTORS; AMBULATORY CARE; CALIFORNIA; CHILD; CHILD, PRESCHOOL; CHOICE BEHAVIOR; COMPETITIVE MEDICAL PLANS; FEMALE; HOSPITALIZATION; HUMANS; INFANT; MALE; MEDICAID; MIDDLE AGED; OUTCOME ASSESSMENT (HEALTH CARE); POISSON DISTRIBUTION; QUALITY OF HEALTH CARE; SEX FACTORS; TIME FACTORS; UNITED STATES; YOUNG ADULT;

EID: 77958187334     PISSN: 00900036     EISSN: 15410048     Source Type: Journal    
DOI: 10.2105/AJPH.2009.182451     Document Type: Article

References (26)

1. "Choose & Book." Patient's Choice of Hospital and Booked Appointment Policy Framework for Choice and Booking at the Point of Referral. Available at: Http:// www.dh.gov.uk. Accessed June 22, 2009.
2. Enthoven AC, van de Ven WP. Going Dutch- managed-competition health insurance in the Netherlands. N Engl J Med. 2007;357(24):2421-2423.
3. Enthoven AC. The history and principles of managed competition. Health Aff. 1993;12(suppl 1):24-48.
4. Le Grand J. Motivation, Agency, and Public Policy: Of Knights & Knaves, Pawns & Queens. Oxford, United Kingdom: Oxford University Press; 2003.
5. Emanuel EJ, Brett AS. Managed competition and the patient-physician relationship. N Engl J Med. 1993; 329(12):879-882.
6. Nichols LM, Ginsburg PB, Berenson RA, Christianson J, Hurley RE. Are market forces strong enough to deliver efficient health care systems? Confidence is waning. Health Aff (Millwood). 2004;23(2):8-21.
7. Mechanic D. The managed care backlash: Perceptions and rhetoric in health care policy and the potential for health care reform. Milbank Q. 2001;79(1):35-54 III-IV.
8. America's Health Insurance Plans. AHIP Statement on House Health Care Reform Discussion Draft. Available at: Http://www.ahip.org/content/pressrelease. aspx?docid=27496. Accessed July 2, 2009.
9. Cunningham PJ, Hadley J. Effects of changes in incomes and practice circumstances on physicians' decisions to treat charity and Medicaid patients. Milbank Q. 2008;86(1):91-123.
10. Cunningham PJ, May JH. Medicaid Patients Increasingly Concentrated Among Physicians. Washington, DC: Center for Studying Health System Change; 2006. Tracking Report no. 16.
11. Centers for Medicare & Medicaid Services. Medicaid Managed Care. Available at: Http://www.cms.hhs.gov/ MedicaidManagCare. Accessed June 22, 2009.
12. Coughlin TA, Long SK, Triplett T, et al. Florida's Medicaid reform: Informed consumer choice? Health Aff (Millwood). 2008;27(6):w523-w532.
13. AHRQ Quality Indicators. Prevention Quality Indicators Overview. Rockville, MD: Agency for Healthcare Research and Quality; 2004. Available at: Http://www.qualityindicators.ahrq.gov/pqi-overview. htm. Accessed June 22, 2009.
14. International Classification of Diseases (ICD). World Health Organisation. Available at: Http://www.who.int/ classifications/icd/en/index. html. Accessed September 10, 2010.
15. Bindman AB, Grumbach K, Osmond D, et al. Preventable hospitalizations and access to health care. JAMA. 1995;274(4):305-311.
16. Bindman AB, Chattopadhyay A, Osmond DH, Huen W, Bacchetti P. The impact of Medicaid managed care on hospitalizations for ambulatory care sensitive conditions. Health Serv Res. 2005;40(1):19-38.
17. Weissman JS, Gatsonis C, Epstein AM. Rates of avoidable hospitalization by insurance status in Massachusetts and Maryland. JAMA. 1992;268(17):2388-2394.
18. Gaynor M. What do we know about competition and quality in health care markets? Cambridge, MA: National Bureau of Economic Research; 2006. NBER Working Paper no. 12301. Available at: Http://www.nber.org/ papers/w12301. Accessed August 4, 2010.
19. Morrisey MA. Competition in hospital and health insurance markets: A review and research agenda. Health Serv Res. 2001;36(1, part 2):191-222.
20. Liu H, Phelps CE. Nonprice competition and quality of care in managed care: The New York SCHIP market. Health Serv Res. 2008;43(3):971-987.
21. Scanlon DP, Swaminathan S, Lee W, Chernew M. Does competition improve health care quality? Health Serv Res. 2008;43(6):1931-1951.
22. Fraser I, Chait E, Brach C. Promoting choice: Lessons from managed Medicaid. Health Aff (Millwood). 1998; 17(5):165-174.
23. Halpern SD, Ubel PA, Asch DA. Harnessing the power of default options to improve health care. N Engl J Med. 2007;357(13):1340-1344.
24. National Committee for Quality Assurance. HEDIS: Healthcare effectiveness data and information set. Available at: Http://www.ncqa.org/tabid/78/Default. aspx. Accessed July 16, 2009.
25. Fairbrother G, Jain A, Park HL, Massoudi MS, Haidery A, Gray BH. Churning in Medicaid managed care and its effect on accountability. J Health Care Poor Underserved. 2004;15(1):30-41.
26. Brandon WP, Troyer JL, Sundaram R, Schoeps N, Sun Y, Walsh BJ. Medicaid enrollee switching among managed care plans. J Health Care Poor Underserved. 2005;16(4):760-779.