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

by John D. Wilkerson, Kelly J. Devers, Ruth S. Given

Overview

The Emerging U.S. Health Care System

The first comprehensive assessment of the new managed care and its potential for addressing the health delivery problems facing the nation.
—Stephen M. Shortell, A. C. Buehler, Distinguished Professor of Health Services Management and professor of organization behavior, J. L. Kellogg Graduate School of Management, Northwestern University

A distinguished group of sixteen health care experts identify and assess the challenges and opportunities raised by the U.S.'s emerging competitive health care system. This timely book looks at the managed forms of care that are thriving in today's competitive bottom line
environment. A thoughtful commentary on the major trends in health care, this book provides a much needed resource for health care providers and government policymakers.

Product Details

ISBN-13:	9780787903091
Publisher:	Wiley
Publication date:	09/30/1996
Series:	Jossey-Bass Health Series
Pages:	422
Product dimensions:	6.34(w) x 9.65(h) x 1.24(d)

About 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.

Table of Contents

UNDERSTANDING COMPETITIVE MANAGED CARE.

The Emerging Competitive Managed Care Marketplace (J. Wilkerson, et al.).

Perspectives and Evidence on Efficiency in Managed Care Organizations (H. Luft).

PRIVATE SECTOR INITIATIVES AND RESPONSES.

The Role of Purchasing Groups (L.Bergthold & L. Solomon).

Exercising Purchasing Power for Prevention (H. Schauffler & T. Rodriguez).

The Challenge of Measuring and Monitoring Quality (A. Bindman).

The Future of the Health Professions Under Managed Care (E. O'Neil & L. Finnocchio).

Inside the System: The Patient-Physician Relationship in the Era of Managed Care (H. Waitzkin & J. Fishman).

PUBLIC SECTOR INITIATIVES AND RESPONSES.

Ensuring Competition in the Market for HMO Services (R. Given).

State-Sponsored Health Insurance Purchasing Cooperatives: California's "HIPC" (T. Buchmueller).

Managing the Managed Care Revolution: States and the New Medicaid (M. Sparer).

The Challenges of Implementing Market-Based Reform for Public Clients (K. Devers).

Messing with Medicare: Markets and Politics in the 104th Congress (J. Wilkerson).

Lessons for the United States: Britain's Experience with Managed Competition (D. Light).

Conclusion: The Potential and Limits of Competitive Managed Care.

Editorial Reviews

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.

Doody's Review Service

"Wilkerson, Devers, and Given have developed a timely, well-integrated collection of articles on competitive managed care. This is a very thoughtful treatment of today's health care issues and merits our reading and reflective consideration." —Richard M. Burton, D.B.A., Professor Fuqua School of Business, Duke University, Inquiry

"The first comprehensive assessment of the new managed care and its potential for addressing the health delivery problems facing the nation. Important reading for policymakers, policy analysts, researchers, and students alike." —Stephen M. Shortell, A. C. Buehler, Distinguished Professor of Health Services Management and professor of organization behavior, J. L. Kellogg Graduate School of Management, Northwestern University

Wilkerson, Devers, and Given have produced a ‘must-read' text for physician leaders, health managers, and health policymakers and students interested in comparing economic theory and principles with what is actually happening in the competitive managed care marketplace. I found every chapter fascinating and very useful.' —John C. Lewin, executive vice president/CEO, California Medical Association

"A balanced and readable text that unravels the complexity of our government-regulated health care marketplace. By examining the perspectives of important stakeholders through both theory and case study, the well-respected editors and authors explain clearly why neither extreme alone (regulation nor free market) would work in the U.S.' —Alan L. Hillman, associate dean and associate professor, School of Medicine, University of Pennsylvania, Philadelphia

From the Publisher

3 Stars from Doody

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.

Bruce J. Fried

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.

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