Suchergebnisse

This study examines all 81 health maintenance organization (HMO) mergers that occurred in the United States from 1985 to 1992. The primary emphasis is on describing organizational factors that are associated with mergers, identifying market environments in which mergers are more likely to occur, and analyzing the financial status of merging HMOs. Overall, the study presents an up-to-date portrait of mergers in this important health care industry. We found that HMO mergers are relatively rare, but, over time, a substantial proportion of HMOs and their enrollees are affected by mergers. Ouranalys is suggests that some financially weak HMOs might have failed if they had not merged into stronger plans. This finding gives qualified support to the failing-company antitrust defense for HMO mergers. However, mergers between large, financially sound HMOs may have anticompetitive effects on consumers of HMO services.

Background: Minnesota enacted legislation in 2007 that requires all health care providers in the state to implement an interoperable electronic health record (EHR) system by 2015. 100% of hospitals and 98% of clinics had adopted EHR systems by end of 2015. Minnesota's 2008 health reform included a health care home (HCH) program, Minnesota's patient centered medical home. By end of 2014, 43% of HCH eligible clinics were certified with 335 certified HCHs and 430 eligible but not certified clinics.

This article examines the general problem of how health maintenance organizations (HMOs) manage service delivery, with specific application to mental health care. The empirical analysis consists of two parts. The first part explores relationships among HMO payment mechanisms and other approaches available to HMO managers to influence the delivery of care. This exploratory analysis identifies four distinct strategies for the management of mental health care delivery. The second part of the empirical analysis relates the adoption of a particular strategy to HMO and market characteristics. One finding from this analysis is that group model HMOs in more competitive markets are more likely to adopt mental health management strategies directed at providers.

In this article, the authors review the health services research literature regarding physician attitudes and opinions relating to managed care and how managed care has affected their clinical practice. This literature suggests that physician perceptions of managed care are largely related to the nature of their ties to managed care plans and to their selection of practice setting. There are substantial limitations in study designs and execution, suggesting that many of the published findings should be viewed with caution; the research basis regarding physicians' perceptions of managed care is not as strong as the number of articles published on this subject would suggest. The review concludes with suggestions for the conduct of future research on this topic.

This article describes issues that should be considered in the development of a theory or theories about incentives from which testable hypotheses could be derived. Economic, psychological, and organizational theories are described, and issues that should be considered in hypothesis generation are presented. Psychological factors influencing incentives include decision framing, regret, heuristics, and reinforcements. Organizational factors influencing incentives include bundling of services or people, matching of incentive structure with work organization, and the incompletely contained hierarchical nesting of incentives. Finally, the dynamics of incentive change are considered, with a focus on describing the conditions under which physicians and physician organizations respond to incentive changes.