摘要:

A10-year experience of managing a capitated ophthalmology carve-out by an academic health unit is presented. Lessons learned regarding pricing, utilization, and managing this contract are discussed. Handling the cost of education and remaining competitive is presented as a not-insurmountable hurdle. Academic health units can compete in today's environment; however, the learning curve is steep and the problems many.

ISSN:0148-9917    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The performance of a health services organization is affected by the cumulative behavior of physicians out of proportion to their numbers or the economic value of their services. Managers are challenged to optimize physician behavior and to change it in concert with the evolving expectations of health service customers. Incentives are the tools available for this effort. This article discusses the interrelation of physician behavior, physician needs, and the major classes of incentives: economic, noneconomic, and rules. While most organizations recognize and use financial incentives, few utilize noneconomic incentives systematically. Given the financial restrictions of advanced markets, managers should understand the role of rules and the value of noneconomic issues to physicians when developing incentive programs.

ISSN:0148-9917    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Health care is a service industry. A fundamental attribute of many successful service industries is the “small replicable unit (SRU).” There are three essential elements of an SRU: (1) the smallest core unit of activity, (2) micromeasures designed to help manage the core activities, and (3) combinations of the activities and measures to match local customer needs. In this article, we describe a model for geriatric care based on “SRU thinking.” We demonstrate how this approach places measurement of patient values, clinical improvement strategies, and research objectives into day-to-day health care deliver.

ISSN:0148-9917    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The range of physician financial arrangements with managed care and insurers, as well as practice arrangements, is becoming increasingly complex. Little is known systematically about these changes, yet there is growing evidence that financial arrangements, utilization management, and other practice characteristics make a substantial difference in treatment patterns, patient mix, and costs of care. Current data systems and surveys frequently do not capture the new information needed to track these changes. New elements of information should be included in national surveys and in a national physician database. A list of recommended data items for a national data base is provided as a starting point for identifying a minimal data set to be included in national statistical systems.

ISSN:0148-9917    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

There are many barriers to measuring client satisfaction for a Medicaid population. This vulnerable group is poor, often undereducated, and highly mobile, making both telephone surveys and mail-return surveys difficult to administer successfully. The Oregon Health Plan (OHP), a Medicaid managed care delivery system, has developed a client satisfaction survey and approach that yielded a 63% response rate. Readability, satisfaction indicators reflective of a Medicaid population, and survey administration are all identified as essential to an adequate response rate. The data from the 1996 Oregon Health Plan Client Satisfaction Survey are being used in the OHP's analysis and evaluation program and its ongoing quality improvement process.

ISSN:0148-9917    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

As many Medicaid patients move into managed care, it is important that physicians competing to serve these patients understand the factors that lead to patient satisfaction. This study uses survey data from 7,313 Oregon Medicaid managed care patients to create a model describing how provider effects and health plan effects relate to patients' satisfaction with their medical care and provider. Path analysis was used to test the explanatory power and strength of relationships in the model. Perceived technical and interpersonal physician quality and health plan rating were most strongly linked with these patients' satisfaction with their care and provider.

ISSN:0148-9917    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Primary care centers (PCCs) are increasingly entering into linkages with hospitals that go far beyond the traditional arrangements in which the hospitals serve as backups to the PCCs. The linkages can be for managed care purposes, for training of health professionals in primary care settings, or for other reasons. This article explores the advantages of such arrangements, the organizational forms that the linkages can take, the legal issues, and negotiating the deal.

ISSN:0148-9917    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The German multipayer universal health insurance plan in 1992 consumed 8.7% of its nation's total expenditures. Nevertheless, Its macromanaged approach has allowed until recently for pluralism, decentralization, and self-regulation among providers and sickness funds (not-for-profit, third party payers). With 34.8% more physicians per 1,000 persons, German doctors provided twice as many patient contacts per capita than in the United States. Due to economic constraints and increases in payroll taxes, the Federal Republic of Germany's parliament, with its 1993 health reform plan, virtually froze all payments to providers for a 3-year period. Among other contentious provisions were the following: (1) limiting the entry of new physicians into municipalities that are considered by government health manpower planning experts to be oversupplied in that specialty; (2) requiring community-based physicians to participate in controlling pharmaceutical costs; and (3) eliminating some of the German traditional barriers between their in- and out-of-hospital physicians. This article focuses on how the Germans now micromanage their physician and other ambulatory care services within a macromanaged system that, in terms of patient access, benefits, quality, and cost, should be the envy of the Americans.

ISSN:0148-9917    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0148-9917    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0148-9917    

出版商:OVID    

年代:1997

数据来源: OVID