A perspective on academic medicine from the nationʼs largest managed care purchaser

Fried, B. M.; Besdine, Richard W.

doi:10.1097/00001888-199603000-00018

Cited by 5 publications

(4 citation statements)

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“…Historically, the activities of AHCs have been generously supported through patient care revenues. Managed care companies, however, have shown little interest in paying a premium for patient care services provided by AHC hospitals or for funding their social objectives (Culbertson 1997;Fried and Besdine 1996;Souba 1996;Gold and Chu 1994). If we think of managed care organizations as being in the business of the systematic suppression of cost shifting (Hurley 1997), then it becomes clear how managed care threatens the system of crosssubsidization undergirding the academic health center.…”

Section: Academic Health Centers In the Changing Health Care Marketmentioning

confidence: 99%

“…AHCs are ostensibly disadvantaged in the managed care arena because the care they provide is more costly and less efficient than that provided by their community counterparts (Fried and Besdine 1996;Reuter 1996;Souba 1996). Furthermore, most of the services provided at AHCs are available elsewhere.…”

Section: Academic Health Centers In the Changing Health Care Marketmentioning

confidence: 99%

“…Medicaid HMO enrollees, if given the choice, often seek care at facilities other than AHCs (Martin 1995;Shine 1995). This is particularly relevant because AHCs tend to treat a disproportionately large number of Medicaid patients (Fried and Besdine 1996;Souba 1996;Goldman 1995) and have relied heavily on Medicaid payments in the past decade.…”

Section: Threats To the Provision Of Patient Carementioning

confidence: 99%

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Academic Health Centers and the Changing Health Care Market

Freburger

Hurley

1999

Med Care Res Rev

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Academic health centers (AHCs) have supported their mission of patient care, education, and research through a complex system of cross-subsidies, many of which originate from patient care activities. The proliferation of managed care and health care reform initiatives, however, are threatening this traditional method of financing. This article begins by describing the financing of AHCs and the web of cross-subsidization that occurs at these institutions. The article then reviews the literature on the threats that AHCs are facing in the current health care market, how these threats are affecting their mission-related activities, and how they are responding to and managing these threats. The article concludes with a summary of our current understanding of AHCs and presents a research agenda of issues in need of further study.

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Section: Academic Health Centers In the Changing Health Care Marketmentioning

confidence: 99%

Section: Academic Health Centers In the Changing Health Care Marketmentioning

confidence: 99%

Section: Threats To the Provision Of Patient Carementioning

confidence: 99%

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Academic Health Centers and the Changing Health Care Market

Freburger

Hurley

1999

Med Care Res Rev

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“…Both Medicaid and Medicare patients are increasingly being served their medical care via MCOs. Over 61 million poor, aged, and chronically ill Americans are affected by these public insurance programs; this transformation has profound implications for (14). The transformation of Medicaid is even more dramatic: Medicaid managed care enrollment grew over 50%, reaching nearly 12 million individuals--representing one third of all program beneficiaries.…”

Section: Future Trends Influencing Cancer Clinical Trialsmentioning

confidence: 99%