scholarly journals Regulation & Managed Care: An Empirical Examination of State OB/GYN Laws

1999 ◽  
Vol 7 (1) ◽  
pp. 5
Author(s):  
Brian Veronda
Keyword(s):  
Managed Care ◽  
Empirical Model ◽  
Active Role ◽  
Health Plans ◽  
Empirical Examination ◽  
Care Plans ◽  
Political Theories ◽  
Democratic Control ◽  
Care Health ◽  
Female Legislators

Since 1995, states have played an increasingly active role as regulators of managed care health plans. However, there is little consistency from state to state in the laws that govern managed care plans. This paper analyzes this inconsistency within the framework of the economic and political theories of regulatory choice. An empirical model is developed to test whether these theories can explain the presence of two laws regulating women's access to obstetrician-gynecologists (OB/GYNs). The results suggest that these theories together do help to clarify why certain states enacted the regulations. The regulations were more likely to be present in states with a relatively high number of OB/GYNs and female legislators, and Democratic control of government.

Dimensions of Consumer-Assessed Quality of Medicare Managed-Care Health Plans

Medical Care ◽  
2000 ◽  
Vol 38 (2) ◽  
pp. 162-174 ◽  
Author(s):  
Alan M. Zaslavsky ◽  
Nancy Dean Beaulieu ◽  
Bruce E. Landon ◽  
Paul D. Cleary
Keyword(s):  
Managed Care ◽  
Health Plans ◽  
Care Health

scholarly journals Using Survey Measures to Assess Risk Selection among Medicare Managed Care Plans

2002 ◽  
Vol 39 (2) ◽  
pp. 138-151 ◽  
Author(s):  
Alan M. Zaslavsky ◽  
Melinda J. Beeuwkes Buntin
Keyword(s):  
Managed Care ◽  
Chronic Conditions ◽  
Financial Risk ◽  
Health Needs ◽  
Health Conditions ◽  
Risk Selection ◽  
Health Plans ◽  
Geographical Differences ◽  
Care Plans ◽  
Consumer Assessments

This paper quantifies risk selection among competing Medicare managed care plans, using beneficiary survey data from the Consumer Assessments of Health Plans Survey®. Selection, measured by variation in plan-level prevalence of health conditions and predicted costs, was substantial. A plan with moderate (one standard deviation) adverse selection would have predicted costs 11.6% above an average plan. Only a small part of this variation was explained by the geographical differences in the prevalence of health conditions among or within Metropolitan Statistical Areas, indicating that the selection was driven by plan attributes. Plans serving members with greater health needs have the potential to establish programs to serve these sick members well, yet this places plans at financial risk. Hence, improved risk adjustment for chronic conditions may be warranted. Moreover, survey measures have the potential to measure the prevalence of such conditions reliably and consistently across plans.

scholarly journals Health Utility Scores for People With Type 2 Diabetes in U.S. Managed Care Health Plans: Results from Translating Research Into Action for Diabetes (TRIAD)

Diabetes Care ◽  
2012 ◽  
Vol 35 (11) ◽  
pp. 2250-2256 ◽  
Author(s):  
P. Zhang ◽  
M. B. Brown ◽  
D. Bilik ◽  
R. T. Ackermann ◽  
R. Li ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Managed Care ◽  
Health Utility ◽  
Health Plans ◽  
Care Health ◽  
Utility Scores
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