managed competition


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managed competition

n.
A theory of health care delivery services that holds that the quality and efficiency of such services would improve if, in a market controlled by the federal government, independent groups had to compete for health care consumers.

managed competition

A healthcare system of historic interest proposed by the Jackson Hole Group, in which insurance companies and providers (i.e., physicians and others) would create health plans to compete with each other for large blocks of consumers.

Under managed competition (MC), individual employees would have received a fixed sum from the employer and chosen a health plan; if the plan chosen cost more than the employer’s fixed sum, the employee would be responsible for the priced options because the employee would be able to deduct only the amount of the lowest cost option. The proposal’s proponents believed that this would encourage individual consumers of healthcare to be more price conscious; they also believed that this would have caused healthcare insurers to hold down the cost of their plans and make them more competitive. Because insurance under this proposed system was not tied to employer, employees would not lose coverage when they changed jobs, and under the proposed system, there was no provision to set premiums that appropriately cover the risk of an individual patient or a specific patient population.

MC was defined by its key architect, Alain Einthoven of Stanford University, as a purchasing strategy with empowered (consumer) demand designed to reward cost-efficient quality care. In MC, consumers would have been organised into large health-purchasing groups to buy insurance; healthcare providers would have been organised in a network that would vie for the health-purchasing group’s business, which would have sufficient clout to bargain with the network to obtain the best value (i.e., cost per individual).

managed competition

In health care practice, the requirement that health care organizations compete with each other in terms of price and quality of delivered services.
See: managed care; resource-based relative value scale
References in periodicals archive ?
Their analysis shows that the introduction of managed competition, based on patient choice and diagnosis-related groups (DRGs), led Northern and Central Regions to increase patient inflows coming from Southern Regions, thus worsening the traditional North-South divide and the social and territorial inequalities in the Italian NHS.
His new book, Health Care, the Market and Consumer Choice, begins at this proposal and chronicles his trials through politics, academia, and international consulting to make managed competition a reality.
Managed competition is finally happening in Massachusetts.
This brings us back to our key question: how did Ontario's managed competition reform affect the ability of home-care rehabilitation professionals to control the content and context of their professional work?
Len Nichols grants that "a single-payer system with managed competition is the best form of single-payer system around.
The managed competition model is characterized by the following:
Advocates of managed competition and large deductibles share the belief that "overuse" of medical care explains the high cost of health care in the US.
The underlying premise behind managed competition is that unlike the public monopolies that dominate public service delivery, competition among service providers--public and private--provides an incentive to control costs, respond quickly to change, emphasize customer satisfaction, and embrace innovation.
Managed competition, the default policy under which we have operated for the past 20 years, has fallen into disfavor with both providers and consumers.
Prioritize opportunities for managed competition and develop timelines for implementation: and
These program descriptions, selected from the Examples of Programs for Cities' database, show how some cities are utilizing privatization and managed competition to help them run more efficiently and effectively.
sets the question of health-care reform against the delicate success of significant coverage, however rationed, of healthcare benefits in Oregon, and against attempts at managed competition by Florida, Vermont, Washington, Hawaii, and Minnesota.

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