San Diego: as a market matures, networks feel growing pains

Article Abstract:

The San Diego, CA, health care market is in the process of entering a new phase as it consolidates and eliminates some existing plans and networks. National Institute for Medical Management Services Pres Donald Shubert believes that the San Diego market foreshadows the future of the US health care system. It has one of the nation's most mature network and managed care markets, and capitation is its dominant characteristic. The commercial health insurance market there is about 60% capitated, and physician groups are narrowing their network and IPA affiliations.

Health Maintenance Organizations, HMO Medical Centers, California, Capitated payment systems (Medical care), San Diego, California

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Sizing up Pennsylvania: Geisinger aims to reshape its delivery system

Article Abstract:

The Geisinger Foundation operates a healthcare network in central Pennsylvania comprised of a large hospital, a secondary care referral center, an in-patient chemical dependency center, a health maintenance organization and a 500-member group practice. The organization has clearly articulated its vision and mission statement; for example, managed care is the foundation's primary business strategy. It carefully tailors its physician mix and facilities to the needs of the communities it serves and conducts computerized quality assurance and utilization reviews.

Health facilities, Managed care plans (Medical care), Health care reform, Pennsylvania, Health facility affiliations, Geisinger Foundation

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Money & management

Article Abstract:

Physicians and investors alike are being attracted to for-profit management firms, which seem to promise doctors greater security than hospitals and insurers. Such companies purchase physician practices in exchange for running the business side of the operation and letting the doctors tend to the medicine. In addition to accepting financial risks associated with running a practice, the firms take responsibility for providing patients and facilities. Investors like the prospects of continued growth and are buying stock at perceived bargain prices.

Physicians, Medical professions

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