Biomaterial Database

Trends in managed care contracting among U.S. hospitals. 1995

K Gautam, and C Campbell, and B Arrington

Department of Health Administration, School of Public Health, Saint Louis University, Missouri, USA.

This article describes the changing profile of hospitals initiating managed care contracts as of 1992. Based on statistical tests, early contractors rank higher on profitability, case mix, bed size, affiliation, and urban location. In contrast, recent and noncontractors are predominantly rural, freestanding hospitals with low case mix, low profitability, high subacute services, and government ownership. A number of lessons for the future are drawn and a stage-by-stage approach to studying managed care issues is proposed.

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
D008389	Marketing of Health Services	Application of marketing principles and techniques to maximize the use of health care resources.	Health Services Marketing,Marketing Services, Health,Marketing, Health Services,Services, Health Marketing,Health Marketing Service,Health Marketing Services,Marketing Service, Health
D009935	Organizational Affiliation	Formal relationships established between otherwise independent organizations. These include affiliation agreements, interlocking boards, common controls, hospital medical school affiliations, etc.	Affiliation, Organizational,Affiliations, Organizational,Organizational Affiliations
D010067	Ownership	The legal relation between an entity (individual, group, corporation, or-profit, secular, government) and an object. The object may be corporeal, such as equipment, or completely a creature of law, such as a patent; it may be movable, such as an animal, or immovable, such as a building.	Property Rights,Property Right,Rights, Property
D012051	Reimbursement Mechanisms	Processes or methods of reimbursement for services rendered or equipment.	Mechanism, Reimbursement,Mechanisms, Reimbursement,Reimbursement Mechanism
D002391	Catchment Area, Health	A geographic area defined and served by a health program or institution.	Health Service Area,Health Catchment Area,Service Area, Health,Area, Health Catchment,Area, Health Service,Areas, Health Catchment,Areas, Health Service,Catchment Areas, Health,Health Catchment Areas,Health Service Areas,Service Areas, Health
D003284	Contract Services	Outside services provided to an institution under a formal financial agreement.	Services, Contract,Contract Service,Service, Contract
D003625	Data Collection	Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data.	Data Collection Methods,Dual Data Collection,Collection Method, Data,Collection Methods, Data,Collection, Data,Collection, Dual Data,Data Collection Method,Method, Data Collection,Methods, Data Collection
D005377	Financial Management, Hospital	The obtaining and management of funds for hospital needs and responsibility for fiscal affairs.	Hospital Financial Management,Hospital Financial Managements,Financial Managements, Hospital,Management, Hospital Financial,Managements, Hospital Financial
D006739	Hospital Administration	Management of the internal organization of the hospital.	Hospital Organization and Administration,Organization and Administration, Hospital,Administration, Hospital