Project Categories

Partially Managed Competition: How Much is Enough?

Award Year: 1998 Investigator: Richard Kronick
Public policy, at the federal and state levels, assumes that competition among health plans will produce increased value for consumers. But the managed competition theory on which much of this is based assumes that the market would, in fact, be managed. In reality, neither large employers nor government payers are fulfilling their roles as sponsors and fully managing competition as the theory suggested they should.

Rationality and Consent in the New Medical Marketplace

Award Year: 1996 Investigator: M. Gregg Bloche
Conflicts have erupted among patients, providers, and payers as a result of the market-driven transformation of the American health care system. These are playing out in coverage decisions by payers, selective contracting between plans and providers, tort liability cases, disclosure and consent issues, and the protection of health information privacy. Dr.

Health Policy and the Creation, Distribution and Destruction of Value in the Changing Health Care Market

Award Year: 1995 Investigator: J.B. Silvers
Dr. Silvers seeks to better understand what is happening and why in the changing health care environment by following the dollars. He: 1) identifies critical ownership and capital transactions in health care (sales, mergers, and discontinuance of operations); 2) estimates resulting changes in economic value; and 3) assesses the underlying environmental and policy drivers behind industry restructuring.

How Well Does Employment-Based Health Insurance Pool Risk?

Award Year: 1995 Investigator: Mark Pauly
Private employment-based insurance pools some of the risk of high medical care expenses across individuals. How well it achieves protection against risk is not well known, but belief that pooling is imperfect especially for employment-based coverage furnished by small groups supports many actual and proposed insurance regulations, reforms, tax advantages, and explicit subsidies. Dr.

The Employer-Based Health Insurance System

Award Year: 1995 Investigator: Sherry Glied
Within the framework of health policy and U.S. labor market changes, Dr. Glied takes a close look at employer-based health insurance, its strengths and weaknesses. She examines: how employer-based insurance systems operate and perform in response to changes in the health care market; increasing differentiation among health plans; an apparent reduction in the number of long-term jobs; and the shifting demographic composition of the U.S. labor force.

Antitrust Policy and the Transformation of Health Care Markets

Award Year: 1994 Investigator: Martin Gaynor, Deborah Haas-Wilson
This study examines antitrust policy in the context of integrated provider networks. While increasing collaboration and integration of medical providers may be consistent with the goal of reducing health care costs, antitrust laws are written to promote and protect competition, not collaboration. Drs.