Cost and quality trends under managed care: is there a learning curve in behavioral health carve-out plans?

Article Abstract:

Organizational learning curves track firm performance improvements over time as their experience increases. They shape the dynamics of an evolving industry and have direct ramifications for regulation. A study estimated the amount of clinical cost reductions in managed behavioral health plans (also called carve-outs) that can be attributed to organizational learning as against general time trends or economies of scale. The analysis focused on data from 52 employer-sponsored managed behavioral health plans offered by 22 employers that completed their first year of operation between 1991 and 1996.

Direct Health and Medical Insurance Carriers, Medical Care Insurance, Case studies, Organizational effectiveness, Health insurance, Learning curves, Experience curves, Mental health benefits

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The effect of financial pressure on the quality of care in hospitals

Article Abstract:

The study using health outcomes after the treatment for Acute Myocardial Infarction (AMI) shows two types of financial pressures, fiscal pressure from the Prospective Payment System (PPS) for inpatient care, and changes in Health Maintenance Organization (HMO) penetration at the country level.

Services information, Care and treatment, Economic aspects, Services, Health care industry, Acute myelocytic leukemia

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The effect of HMOs on fee-for-service health care expenditures: evidence from medical revisited

Article Abstract:

A new strategy for the selection of Medicare Health Maintenance Organisation (HMO) enrollees based on average costs between new Medicare HMO enrollees and Medicare fee-for-service stayers is analyzed.

United States, Management dynamics, Analysis, Medical care, Cost of, Health care costs, Company business management

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