Context Managed care has the potential to transform fundamentally the structure and functioning of the entire health care system, including the care provided to patients who are not enrolled in managed care plans.
Objective To determine whether increasing health maintenance organization (HMO) market share is associated with decreased expenditures for the care of patients covered by Medicare's traditional fee-for-service plan, a group cared for well outside the boundaries of managed care.
Design and Setting Data from the Health Care Financing Administration were used to compare expenditures for the care of Medicare fee-for-service beneficiaries for 802 market areas, representing the entire United States, for 1990 to 1994.
These data were matched with data on system-wide (Medicare and non-Medicare) HMO market share in these areas.
Patients All fee-for-service Medicare beneficiaries (1990-1994) except for those with end-stage renal disease.
Main Outcome Measure Average fee-for-service expenditure per fee-for-service Medicare beneficiary by market area.
Results In a regression model, increases in system-wide HMO market share were associated with declines in both Part A and Part B fee-for-service expenditures per Medicare beneficiary (P<. 001).
Increases from 10% market share to 20% market share were associated with 2.0% decreases in Part A fee-for-service expenditures and 1.5% decreases in Part B fee-for-service expenditures. (...)
Mots-clés Pascal : Soin intégré, Economie santé, Organisation santé, Système santé, Homme, Etats Unis, Amérique du Nord, Amérique, Medicare, Health maintenance organization
Mots-clés Pascal anglais : Managed care, Health economy, Public health organization, Health system, Human, United States, North America, America
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0120596
Code Inist : 002B30A01B. Création : 16/11/1999.