Biomaterial Database

A community approach to health care competition. 1987

R C Bradbury

Graduate School of Management, Clark University, Worcester, MA 01610.

In the Worcester, Massachusetts, area, a community program is making health care more affordable through competition among managed-care health plans. Business and health care leaders have joined to assure that this competition focuses not only on price but also on quality and service, and that it benefits the entire community, including the elderly, poor, and uninsured. This paper describes the progress of the program to date as well as strategies for overcoming obstacles to further success.

UI	MeSH Term	Description	Entries
D008329	Managed Care Programs	Health insurance plans intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, such as HEALTH MAINTENANCE ORGANIZATIONS and PREFERRED PROVIDER ORGANIZATIONS.	Case Management, Insurance,Insurance Case Management,Managed Health Care Insurance Plans,Managed Care,Care, Managed,Managed Care Program,Management, Insurance Case,Program, Managed Care,Programs, Managed Care
D008404	Massachusetts	State bounded on the north by New Hampshire and Vermont, on the east by the Atlantic Ocean, on the south by Connecticut and Rhode Island, and on the west by New York.
D011243	Preferred Provider Organizations	Arrangements negotiated between a third-party payer (often a self-insured company or union trust fund) and a group of health-care providers (hospitals and physicians) who furnish services at lower than usual fees, and, in return, receive prompt payment and an expectation of an increased volume of patients.	Organizations, Preferred Provider,Preferred Provider Organization,Organization, Preferred Provider
D011785	Quality Assurance, Health Care	Activities and programs intended to assure or improve the quality of care in either a defined medical setting or a program. The concept includes the assessment or evaluation of the quality of care; identification of problems or shortcomings in the delivery of care; designing activities to overcome these deficiencies; and follow-up monitoring to ensure effectiveness of corrective steps.	Quality Assessment, Health Care,Health Care Quality Assessment,Health Care Quality Assurance,Healthcare Quality Assessment,Healthcare Quality Assurance,Quality Assessment, Healthcare,Quality Assurance, Healthcare,Assessment, Healthcare Quality,Assessments, Healthcare Quality,Assurance, Healthcare Quality,Assurances, Healthcare Quality,Healthcare Quality Assessments,Healthcare Quality Assurances,Quality Assessments, Healthcare,Quality Assurances, Healthcare
D003153	Community Health Services	Diagnostic, therapeutic and preventive health services provided for individuals in the community.	Community Health Care,Community Healthcare,Health Services, Community,Services, Community Health,Community Health Service,Health Care, Community,Health Service, Community,Healthcare, Community,Service, Community Health
D003695	Delivery of Health Care	The concept concerned with all aspects of providing and distributing health services to a patient population.	Delivery of Dental Care,Health Care,Health Care Delivery,Health Care Systems,Community-Based Distribution,Contraceptive Distribution,Delivery of Healthcare,Dental Care Delivery,Distribution, Non-Clinical,Distribution, Nonclinical,Distributional Activities,Healthcare,Healthcare Delivery,Healthcare Systems,Non-Clinical Distribution,Nonclinical Distribution,Activities, Distributional,Activity, Distributional,Care, Health,Community Based Distribution,Community-Based Distributions,Contraceptive Distributions,Deliveries, Healthcare,Delivery, Dental Care,Delivery, Health Care,Delivery, Healthcare,Distribution, Community-Based,Distribution, Contraceptive,Distribution, Non Clinical,Distributional Activity,Distributions, Community-Based,Distributions, Contraceptive,Distributions, Non-Clinical,Distributions, Nonclinical,Health Care System,Healthcare Deliveries,Healthcare System,Non Clinical Distribution,Non-Clinical Distributions,Nonclinical Distributions,System, Health Care,System, Healthcare,Systems, Health Care,Systems, Healthcare
D004465	Economic Competition	The effort of two or more parties to secure the business of a third party by offering, usually under fair or equitable rules of business practice, the most favorable terms.	Competition, Economic,Competitions, Economic,Economic Competitions
D004467	Economics	The science of utilization, distribution, and consumption of services and materials.	Consumer Price Index,Capital,Conditions, Economic,Consumption,Cost of Living,Easterlin Hypothesis,Economic Conditions,Economic Policies,Economic Policy,Economics, Home,Home Economics,Household Consumption,Macroeconomic Factors,Microeconomic Factors,Policies, Economic,Policy, Economic,Production,Remittances,Utility Theory,Condition, Economic,Consumer Price Indices,Consumption, Household,Economic Condition,Factor, Macroeconomic,Factor, Microeconomic,Factors, Macroeconomic,Factors, Microeconomic,Household Consumptions,Hypothesis, Easterlin,Index, Consumer Price,Indices, Consumer Price,Living Cost,Living Costs,Remittance,Theories, Utility,Theory, Utility,Utility Theories
D004526	Efficiency	Ratio of output to effort and or resources, or the ratio of effort and or resources produced to energy expended.	Productivity
D005381	Financing, Organized	All organized methods of funding.	Community Financing,Grants,Organized Financing,Financing, Community,Grant