Managed care and innovation in healthcare management: a Brazilian experience

Marciano, Marcelo Antunes; Vaccaro, Guilherme Luís Roehe; Carmo, Annibal José Roris Rodriguez Scavarda do; Nunes, Fabiano de Lima; Nodari, Cristine Hermann

doi:10.1080/20479700.2020.1788333

Cited by 4 publications

(5 citation statements)

References 27 publications

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“…Admittedly, innovation, particularly in the healthcare domain, is vital to the maintenance of product and service quality ( Evren Subasi and Subasi 2021 ; Marika 2021 ). This claim is consistent with the findings of Marciano and others, who, from their empirical study, also conclude that innovation results in reduction of the cost of services ( Marciano et al 2020 ). As well, Halpaap et al (2020) maintain that innovation helps in enhancing transparency and accountability in the healthcare sector, and its overall durability.…”

Section: The Justification Of the Patent System In The Covid-19 Contextsupporting

confidence: 92%

The COVID-19 vaccine patent: a right without rationale

Althabhawi

Al-Ghetaa²

2022

Med Humanities

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Since the approval of COVID-19 vaccines, international efforts have intensified on vaccination schemes perceived as the only light at the end of the tunnel. Governments are working tirelessly to scale up the number of vaccinated people, just as vaccine manufacturers are stretching their facilities to meet the increasing demand for doses. The international community is trying to help the poorest countries in the world by improving vaccine supplies and removing obstacles. In this regard, India and South Africa have applied to World Trade Organisation to waive vaccine-related intellectual property rights. The proposal has sparked off academic debates as to its merit. This article addresses the waiver controversy. Following a critical review of both dimensions of the controversy, the article concentrates on the extent to which the waiver application contradicts the theoretical justification of the patent system. It concludes that the concerns raised over the conflict between the waiver proposal and the patent right philosophy are indefensible.

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Section: The Justification Of the Patent System In The Covid-19 Contextsupporting

confidence: 92%

The COVID-19 vaccine patent: a right without rationale

Althabhawi

Al-Ghetaa²

2022

Med Humanities

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“…The healthcare providing organisations need better compensation for evidence-based innovations [6,21]. Turning attention to context-specific concerns may be necessary to further managed competition [5,6,7,22,23].…”

Section: Healthcare Organisation Contextmentioning

confidence: 99%

“…Business model designs may be needed to attain managed competition contract requirements and PTPHOcentred outcomes [6,15,39]. Several studies recommend that context-specific innovation-driving requirements, and treatment service quality and financial organisationcentred outcomes may need to be included in contracts [10,16,23,27]. However, the healthcare management literature lacks research on the moderating influence that a managed competition contract can have on the relation of business model efficiency and novelty, with PTPHOcentred outcomes [6,20,24].…”

Section: Moderating Influence Of Managed Competition Contractmentioning

confidence: 99%

“…Because of a difference in organisation- level requirements and healthcare system-level requirements, contract requirements may not match the needs at the organisational level [ 46 ]. The healthcare management literature suggests that although business model novelty may enable organisation-centred outcomes, a managed competition contract may hinder PTPHO-centred outcomes because the highest contract requirements focus on rewarding efficiency, not novelty [ 23 ]. For example, although potentially helpful, a novel idea like preventative care instead of curative care may not be reimbursed based on managed competition contract efficiency requirements.…”

Section: Introductionmentioning

confidence: 99%

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The relations between business model efficiency and novelty, and outcome while accounting for managed competition contract: a quantitative study among Dutch physiotherapy primary healthcare organisations

Ijntema

Barten

Duits

et al. 2022

BMC Health Serv Res

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Background Since 2006, business principles have been introduced to foster efficient healthcare by way of managed competition. Managed competition is expressed by a contract between a health insurer and a physiotherapy primary healthcare organisation (PTPHO). In such a managed environment, PTPHOs have to attain treatment service quality and financial PTPHO-centred outcomes Research shows that business model designs may enhance organisation-centred outcomes. A business model is a design (efficiency or novelty) of how a firm transacts with customers, partners, and vendors; how it connects with markets. However, research on managed competition contract and business model designs, in relation to PTPHO-centred outcomes is new to the healthcare literature. PTPHOs may not know how business model designs enhance outcomes. This study aims to delineate the relations between business model efficiency and novelty, and PTPHO-centred outcomes, while accounting for managed competition contract in Dutch healthcare. Methods A quantitative cross-sectional design was adopted. Using a questionnaire, the relations between managed competition, business model efficiency and novelty, and PTPHO-centred outcomes were investigated among PTPHO managers (n = 138). Theory-based expectations were set up and multiple linear regression analyses were applied. Results Managed competition and business model efficiency show no relation with PTPHO-centred outcomes. Moderation of the business model efficiency and PTPHO-centred outcomes relation by managed competition contract is not detected. Business model novelty shows a positive relation with PTPHO-centred outcomes. Moderation of the business model novelty and PTPHO-centred outcomes relation by managed competition contract is found. Conclusions There seem to be positive relations between business model novelty and PTPHO-centred outcomes on its own and moderated by managed competition contract. No relations seem to exist with business model efficiency. This implies that the combination of persistent use of health insurer-driven managed competition contracts and a naturally efficient PTPHOs may have left too few means for these organisations to contribute to healthcare reforms and attain PTPHO-centred outcomes. Organisation-driven innovation could stretch system-level regulations and provide room for new business models. Optimising contracts towards organisation-driven healthcare reform, including novelty requirements and corresponding reimbursements is suggested. PTPHO managers may want to shift their attitudes towards novel business models.

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“…The healthcare management literature suggests that although business model novelty may enable performance, a managed competition contract may hinder PTPHO-centred outcome performance because the highest contract requirements focus on rewarding e ciency, not novelty (34). For example, although potentially helpful, a novel idea like preventative care instead of curative care may not be reimbursed based on managed competition contract e ciency requirements.…”

Section: Moderating Effect Of Managed Competition Contractmentioning

confidence: 99%

The relations between business model efficiency and novelty, and outcome performance while accounting for managed competition contract

Ijntema

Barten

Duits

et al. 2022

Preprint

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Background – Since 2006, with managed competition, business principles have been introduced to foster efficient healthcare. In the Netherlands and elsewhere, managed competition is expressed by a contract between a health insurer and a physiotherapy primary healthcare organisation (PTPHO). In such a managed healthcare environment, PTPHOs have to attain outcomes. Business model designs (efficiency and novelty) may enhance outcome performance. Research on both managed competition contract and business model designs in relation to the dependent variable PTPHO-centred outcome performance is new to the primary healthcare context. This study aims to describe the relations between business model efficiency and novelty, and PTPHO-centred outcome performance, while accounting for managed competition contract in Dutch healthcare. Methods – A quantitative cross-sectional design was adopted. By means of a questionnaire, the concepts were investigated among PTPHO managers. Theory-based expectations were set up and multiple linear regression analyses were applied. Results – Business model novelty and business model novelty moderated by managed competition contract both show a significant positive relation with PTPHO-centred outcome performance. Managed competition contract, business model efficiency, and business model efficiency moderated by a managed competition contract, show no relation with PTPHO-centred outcome performance. Conclusions - There seem to be positive relations between business model novelty and PTPHO-centred outcome performance on its own and moderated by managed competition contract. No relations seem to exist with business model efficiency. The combination of persistent use of health insurer-driven managed competition contracts and a naturally efficient Dutch physiotherapy sector may have left too few means for physiotherapy organisations to contribute to healthcare reforms and perform PTPHO-centred outcomes. PTPHO managers may want to shift their attitudes towards novel business models. The authors suggest optimising contracts towards provider-driven healthcare reform, including novelty requirements and corresponding reimbursements.

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Managed care and innovation in healthcare management: a Brazilian experience

Cited by 4 publications

References 27 publications

The COVID-19 vaccine patent: a right without rationale

The COVID-19 vaccine patent: a right without rationale

The relations between business model efficiency and novelty, and outcome while accounting for managed competition contract: a quantitative study among Dutch physiotherapy primary healthcare organisations

The relations between business model efficiency and novelty, and outcome performance while accounting for managed competition contract

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