Competitive Managed Care: The Emerging Health Care System / Edition 1

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Overview

In this timely book, a distinguished group of sixteen health care experts, including physicians, political scientists, sociologists, and economists, identify and assess the challenges and opportunities raised by America's emerging competitive health care system. As the authors explain, health care markets have characteristics that do not conform to competitive conditions. Freely operating health care markets will not produce and allocate health care services efficiently, and they will not provide the distribution of services that Americans have historically favored.

The book contains black-and-white illustrations.

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Editorial Reviews

Doody's Review Service
Reviewer: Bruce J. Fried, PhD (University of North Carolina Chapel Hill School of Public Health)
Description: This book deals with managed care and market competition based healthcare reforms. The chapters are divided into three major sections dealing with the rationale behind competitive managed care, private sector initiatives, and public sector initiatives. A final chapter projects the future potential and limits of competitive managed care.
Purpose: The purpose is to apply economic theory to the analysis of competitive managed care. The book attempts to review many of the popular arguments extolling the virtues of the marketplace in healthcare and to examine critically the use of a purely economic approach to health system design.
Audience: The book is appropriately targeted to healthcare practitioners, purchasers, and consumers of healthcare services, policymakers and analysts, and graduate students in health policy, public health, and health services management. The editors and contributing authors are well recognized for their expertise.
Features: The chapters in the book are consistent in writing style and sophistication. Although each could stand on its own as a strong commentary on the health system, there is reasonable continuity among chapters. The major organizing framework, besides economic theory, is the distinction between public and private initiatives. Given the many ways that one could organize a group of nonsequential chapters, this is an acceptable organizing framework for the book. The references are current and relevant.
Assessment: A major strength of this book is its accessibility to many audiences. Economic approaches are described simply and accurately for the noneconomist. The book is well researched and in largely empirically based, but it is also quite readable for practitioners and health professionals. Another important strength of the book is its coverage of fundamental issues, such as the economics of managed care, as well as specific initiatives, such as Medicaid managed care.
Bruce J. Fried
This book deals with managed care and market competition based healthcare reforms. The chapters are divided into three major sections dealing with the rationale behind competitive managed care, private sector initiatives, and public sector initiatives. A final chapter projects the future potential and limits of competitive managed care. The purpose is to apply economic theory to the analysis of competitive managed care. The book attempts to review many of the popular arguments extolling the virtues of the marketplace in healthcare and to examine critically the use of a purely economic approach to health system design. The book is appropriately targeted to healthcare practitioners, purchasers, and consumers of healthcare services, policymakers and analysts, and graduate students in health policy, public health, and health services management. The editors and contributing authors are well recognized for their expertise. The chapters in the book are consistent in writing style and sophistication. Although each could stand on its own as a strong commentary on the health system, there is reasonable continuity among chapters. The major organizing framework, besides economic theory, is the distinction between public and private initiatives. Given the many ways that one could organize a group of nonsequential chapters, this is an acceptable organizing framework for the book. The references are current and relevant. A major strength of this book is its accessibility to many audiences. Economic approaches are described simply and accurately for the noneconomist. The book is well researched and in largely empirically based, but it is also quite readable for practitioners and healthprofessionals. Another important strength of the book is its coverage of fundamental issues, such as the economics of managed care, as well as specific initiatives, such as Medicaid managed care.
Booknews
A critical assessment of America's emerging competitive health care system indicating that health care markets have characteristics which will not conform to competitive conditions and thus provide services that Americans expect. The 13 essays, written by physicians, sociologists, and economists, examine the need for greater efficiency of managed forms of care, describe the role that employers play in promoting competition, assess the implications of care changes for nurses and other healthcare workers, and investigate how increased price competition affects the relationship between providers and their patients. Annotation c. by Book News, Inc., Portland, Or.

3 Stars from Doody
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Product Details

  • ISBN-13: 9780787903091
  • Publisher: Wiley
  • Publication date: 9/23/1996
  • Series: Jossey-Bass Health Series
  • Edition description: New Edition
  • Edition number: 1
  • Pages: 405
  • Product dimensions: 1.06 (w) x 6.00 (h) x 9.00 (d)

Meet the Author

JOHN D. WILKERSON Kelly J. Devers, and Ruth S. Given collaborated on this book while they were Robert Wood Johnson Scholars in the Health Policy Research Program at the University of California, Berkeley. John D. Wilkerson is assistant professor of political science at the University of Washington, Seattle. Kelly J. Devers is an expert appointee at the Agency for Health Care Policy and Research, Center for Organization and Delivery. Ruth S. Given is director of the Department of Health Care Policy at the California Medical Association.

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Table of Contents

Preface
Pt. 1 Understanding Competitive Managed Care 1
1 The Emerging Competitive Managed Care Marketplace 3
2 Perspectives and Evidence on Efficiency in Managed Care Organizations 30
Pt. 2 Private Sector Initiatives and Responses 55
3 Group Purchasing in the Managed Care Marketplace 59
4 Exercising Purchasing Power for Prevention 83
5 The Challenge of Measuring and Monitoring Quality 100
6 The Future of the Health Professions Under Managed Care 113
7 Inside the System: The Patient-Physician Relationship in the Era of Managed Care 136
Pt. 3 Public Sector Initiatives and Responses 163
8 Ensuring Competition in the Market for HMO Services 167
9 State-Sponsored Health Insurance Purchasing Cooperatives: California's "HIPC" 198
10 Managing the Managed Care Revolution: States and the New Medicaid 231
11 The Challenges of Implementing Market-Based Reform for Public Clients 259
12 Messing with Medicare: Markets and Politics in the 104th Congress 297
13 Lessons for the United States: Britain's Experience with Managed Competition 322
Conclusion: The Potential and Limits of Competitive Managed Care 357
The Editors 381
The Contributors 383
Name Index 387
Subject Index 395
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