The HMO Industry: Evolution in Population Demographics and Market Structures

Christianson, Jon B.; Sanchez, Susan M.; Wholey, Douglas R.; Shadle, Maureen

doi:10.1177/002570879104800102

Cited by 34 publications

(11 citation statements)

References 34 publications

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“…Between 1985 and 1987, the HMO industry experienced rapid expansion, particularly in the number of individual practice associations, or IPAs [1]. This was followed by industry consolidation (1987 to 1993), after which there was another cycle of slight increase and contraction in the late 1990s.…”

Section: Hmo Average Productivitymentioning

confidence: 99%

“…The resource-based view allows us to understand the relationship between health service use and HMO productivity. We examine HMO average productivity 1 In Table 5 the estimated effect of number of years in operation is j0.01 (p < 0.05), but in the text the authors state Befficiency increases with age of the health plan'' [35]. We use the estimate from Table 5.…”

Section: Hmo Average Productivitymentioning

confidence: 99%

“…A measure for consumer protection was constructed by counting the number of consumer oriented regulations in the HMO's home state: (1) consumer representation on the HMO board; (2) a policymaking role for subscribers; and (3) grievance procedures. The consumer regulations presumably make it more difficult for HMOs to under-provide services.…”

Section: Outputs and Inputsmentioning

confidence: 99%

“…Over the past 25 years, a significant change in health care organization in the United States has been the proliferation of managed care organizations such as Health Maintenance Organizations (HMOs) [1,2]. The development of HMOs was in part predicated on the argument that commingling providers and insurers would lead to competition and higher productivity [3,4].…”

mentioning

confidence: 99%

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A descriptive analysis of average productivity among health maintenance organizations, 1985 to 2001

Wholey

Engberg

Bryce³

2006

Health Care Manage Sci

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This paper examines the evolution of average productivity among HMOs for 4,419 Health Maintenance Organizations (HMOs) from 1985 to 2001. For both IPA and non-IPA HMOs, HMO productivity increased from 1990 to 1996 and rapidly decreased from 1997 to 2001. In contrast to cost functions that show scale economies for IPA and non-IPA HMOs, production functions showed scale economies for IPA HMOs were constant and non-IPA HMOs having only slight scale economies. This suggests that much of the scale economies observed in cost functions are due to lower prices for resources used rather than improvements in production organization. Non-IPA HMOs and non-profit HMOs are more productive than IPA HMOs and for profit HMOs. Production organization for non-IPA HMOs appears to have improved over time, resulting in non-IPA HMOs being able to produce more member months of coverage with their production organization in 1997 to 2001 than they would have with their production organization in 1985 to 1990. Regulations requiring consumer involvement in HMO governance reduce productivity.

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Section: Hmo Average Productivitymentioning

confidence: 99%

Section: Hmo Average Productivitymentioning

confidence: 99%

Section: Outputs and Inputsmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

A descriptive analysis of average productivity among health maintenance organizations, 1985 to 2001

Wholey

Engberg

Bryce³

2006

Health Care Manage Sci

Self Cite

View full text Add to dashboard Cite

show abstract

“…The large number of HMO mergers in 1988 probably represents a shakeout after the industry's rapid expansion in the mid-1980s. 13 This shakeout also included many HMO failures and brought about an increase in the scope and intensity of state legislation and regulatory activity directed at the HMO industry.…”

Section: Health Services Research and Public Policymentioning

confidence: 99%