Canaries In A Coal Mine: California Physician Groups And Competition

Health care organizations may compete by developing organized processes to improve quality and increase efficiency, or may focus on growing to increase negotiating leverage and on controlling costs through withholding appropriate care and avoiding sick patients. This paper describes key ways in whic...

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Bibliographic Details
Published in:Health Affairs 2001-07, Vol.20 (4), p.97-108
Main Author: Casalino, Lawrence
Format: Article
Language:English
Subjects:
Audited financial statements
Business conditions
California
Capitation
Capitation Fee
Coal mines
Competition
Contract negotiations
Economic Competition
Efficiency
Efficiency, Organizational
Group medical practice
Group Practice - economics
Group Practice - organization & administration
Health care
Health care expenditures
Health care policy
Health maintenance organizations
Health Maintenance Organizations - economics
Health Maintenance Organizations - legislation & jurisprudence
Health Maintenance Organizations - organization & administration
HMOs
Hospitalization
Independent practice associations
Managed competition
Patients
Physician Incentive Plans
Physician practice management
Physicians
Policy Making
Private Sector
Public Sector
Quality Assurance, Health Care
Regulation
Studies
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Summary:Health care organizations may compete by developing organized processes to improve quality and increase efficiency, or may focus on growing to increase negotiating leverage and on controlling costs through withholding appropriate care and avoiding sick patients. This paper describes key ways in which public and private policy decisions create incentives that influence the competitive focus of physician groups in California, a state in which physician groups and health maintenance organizations are prevalent. These policies do not manage competition in optimal ways: They reward groups for market leverage and controlling costs while failing to fully reward quality and efficiency.
ISSN:0278-2715
1544-5208
DOI:10.1377/hlthaff.20.4.97