Ideals and realities of academic medical center involvement with HMOs

Willard, William

doi:10.1097/00001888-197304000-00016

Cited by 1 publication

(5 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Delivery-of-service articles, which were rare in the 1970s, began to increase in the 1980s but then experienced a lull in the early 1990s before rebounding recently. In the early years, these articles focused on primary care (Falk 1973;Pawlson and Kaufman 1982;Friedman 1984) rather than tertiary care and specialty services (Sheps 1973;Willard 1973;Heyssel and Seidel 1976;Pawlson and Kaufman 1982); over the past 8 years, the attention has been much more even. Articles referencing medical education have also grown in number, with the split between medical school and residency programs remaining fairly even throughout the years.…”

Section: Subject Matter Trendsmentioning

confidence: 99%

“…While AHCs offered HPs a marketing advantage with their image of high-quality and clinical innovation, most HPs feared this would attract sicker enrollees, an expensive competitive disadvantage (Fox and Wasserman 1993). Of note, no HP benefits were enumerated in articles written in the 1970s (Thompson 1973;Willard 1973).…”

Section: Hp Motivesmentioning

confidence: 99%

“…When HMOs were first created through federal legislation, a local community board was a requirement for federal qualification. This requirement made close association with an HMO threatening to AHCs, which feared community control of their actions (Willard 1973). Over the years, qualification has become less essential for the formation and survival of HPs; consequently, HPs have evolved ways to separate the community role from actual organization control and the delivery of medical care.…”

Section: Relationship Objectivesmentioning

confidence: 99%

“…This review has addressed those motives identified for AHCs. In 1973, concern was expressed that unless HMOs became a setting for teaching and research, they would compromise the unique role of medical schools (Willard 1973) by competing for patients and funding. Carey and Engelhard (1996) confirmed 23 years later that, indeed, medical schools were under such stress.…”

Section: Ahc Motivesmentioning

confidence: 99%

“…No HP benefits were enumerated in articles written in the 1970s (Thompson 1973;Willard 1973). It is not surprising, therefore, that only AHCsponsored HPs established relationships with AHCs, with the exception of two long-established group/staff model HMOs on the West Coast-Kaiser-Permanente of Northern California and Group Health Cooperative of Puget Sound.…”

Section: Hp Motivesmentioning

confidence: 99%

See 4 more Smart Citations

Motives for Health Plan-Academic Health Center Relationships: Journal Review of the First Quarter Century

Parkerton

1999

Med Care Res Rev

View full text Add to dashboard Cite

Motives for health plan (HP)-academic health center (AHC) relationships, including both deterrents and inducements, are explored through a review of 153 articles, published from 1970 through 1997, in academic and health care industry journals about HP-AHC relationships. Every article that met inclusion criteria was coded for year, journal, author, audience, type of article, organization of focus, purposes, priorities, affiliation motives, and issues. Peak years were 1973 (the passage of HMO legislation) and the most recent years from 1994 through 1997. The motives to affiliate were found to be different for AHCs and HPs (e.g., physician attitudes, a deterrent for AHCs and inducement for HPs; resources, a deterrent for HPs and inducement for AHCs). Increases in size of HPs and decreases in political power of AHCs have resulted in changes to motives to form relationships. Motives must be acknowledged to move from competitive to collaborative relationships. PURPOSE OF STUDYIt is now commonplace to observe that the past 25 to 30 years have been a period of substantial organizational change in the health care system. There has been an overwhelming amount of commentary and study that has focused on evolution and change in the expanding variety of healthcare organizations including hospitals, physicians' practices, health care insurers, 106 and employer groups, as well as academic health centers (AHCs) and health plans (HPs). AHCs educate and train the nation's future physicians and other health care professionals, conduct clinical research, and frequently provide medical services to the sickest and often poorest Americans. HPs combine the attributes of medical delivery systems with health insurance and cover the medical needs of a majority of Americans. Together, these two institutional sectors have had a tremendous impact on the quality and availability of medical services in this country. However, the relationships of AHCs and HPs have not been studied in depth. Two current debates make this review of more than passing interest. First, AHCs are experiencing stress in competing in today's cost-constrained health care markets as their costs for education of health professionals, clinical research, and service to impoverished populations continue to increase (Friedman 1997;Moore and Griner 1997;Pardes 1997). Second, recent legislative debates, such as patient's bill of rights and HMO liability, as well as other consumer concerns, have sparked controversy over the quality of care that patients receive from HPs. These challenges exemplify the importance of examining how AHCs and HPs interact with one another as market and regulatory pressures continue to intensify.Application of the organizational literature on alliances would suggest that HPs and AHCs might form alliances in response to market, regulatory, or community forces, particularly if they are in the same service area and/or are suppliers and purchasers of each other's products (Oliver 1990). However, this review of trade and academic reporting of HP-AHC relati...

show abstract