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Trends in Managed Care Cost Containment: An Analysis of the Managed Care Backlash

机译:管理式医疗成本控制的趋势:管理式医疗反弹的分析

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Consumer dissatisfaction with the quality and limitations of managed health care led to rapid disenrollment from managed care plans and demands for regulation between 1998 and 2003. Managed care organizations, particularly health maintenance organizations (HMOs), now face quality and coverage mandates that restrict them from using their most aggressive strategies for managing costs. This paper examines the effect of this backlash on managed care's ability to contain costs among short-term, non-federal hospitals between 1998 and 2008. The results show that the impact of increased HMO penetration on inpatient costs reversed over the study period, but HMOs were still effective at containing outpatient costs. These findings have important policy implications for understanding the continuing role that HMOs should play in cost containment policy and for understanding how effective the latest wave of cost containment institutions may perform in heavily regulated markets. Copyright (c) 2014 John Wiley & Sons, Ltd.
机译:消费者对管理式医疗保健的质量和局限性的不满意导致1998年至2003年之间快速退出管理式医疗保健计划和法规要求。管理式医疗保健组织,特别是健康维护组织(HMO),现在面临的质量和覆盖范围要求使其无法使用他们最积极的策略来管理成本。本文研究了这种强烈反对对1998年至2008年间短期非联邦医院管理式医疗控制成本的能力的影响。结果表明,在研究期间,HMO渗透率的提高对住院费用的影响得到了扭转,但是HMO在控制门诊费用方面仍然有效。这些发现对理解HMO在成本控制政策中应继续发挥的作用以及了解最新一波成本控制机构在严格监管的市场中可能发挥的作用具有重要的政策意义。版权所有(c)2014 John Wiley&Sons,Ltd.

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