Structural incentives and adoption of medical technologies in HMO and fee-for-service health insurance plans

Article Abstract:

Health maintenance organizations (HMOs) and fee-for-service (FFS) health insurance may not only jeopardize public welfare but lead to the adoption of costly and inefficient technologies. It was also found that the utilization rate of new technology is essentially the same for either of the two insurance schemes. In addition, since FFS insurances are more efficient and less inflationary by nature compared to HMO insurance, it was emphasized that no priori policy preference should be adopted when comparing one from the other.

Usage, Insurance industry, Science and technology policy, Medical technology

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Franchise issues - exclusivity of territory

Article Abstract:

Many health care providers and health maintenance organizations have yet to fully comprehend the benefits and limitations of an exclusive territorial license. Licensing agreements between Blue Cross and Blue Shield Assn (BCBSA) and BCBSA health plans allow franchisees to use Assn names and trademarks when selling, marketing and administering health care plans and related services. A shift to nonexclusive licensing might produce uncertain and often disastrous changes in the BCBSA structure.

Analysis, Health care industry, Licensing agreements, Exclusive licenses, Blue Cross and Blue Shield Association

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The impact of HMO competition on private health insurance, 1985-1992

Article Abstract:

The impact of health maintenance organizations (HMO) on fee-for-service indemnity insurance premiums from 1985 to 1992 is studied. Results show that HMO market penetration reduced insurance premium rates. Premium rates grew by 5.9% instead of 7% in areas where HMO penetration reached 25%. These findings imply that managed care can reduce health insurance premiums to produce significant cost savings.

Research, Prices and rates

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