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 ?
While the Clinton task force is toying with some form of a global budget, their managed competition plan will not in itself reduce spending.
Although promising, managed competition remains an untested theory facing a number of significant hurdles.
Rather, the paper essentially argues that a single-payer system with managed competition would do a better job, on balance, of achieving the widely accepted goals of universal coverage, containing costs, protecting patient freedom, and delivering high quality care.
In this second camp, world order is more about managed competition and the balance of power than multilateral cooperation in the pursuit of "fundamental freedoms for all," as per Article 1 of the UN Charter.
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.
While managed competition and gain-sharing haven't taken off across the continent, some cities have used these ideas effectively.
Alain Enthoven envisioned managed competition at a time when it seemed ideologically and logistically impossible.
"Some of the challenges that I see insurance agencies facing are the increased workflow and time involved in quoting and writing insurance as a result of the adoption of managed competition in Massachusetts.
Less than 20 companies wrote auto insurance in Massachusetts before it switched to a "managed competition" system to allow companies to set their own rates.
"INSURANCE EXCHANGES ARE ROOTED IN THE DECADES-OLD CONCEPT OF 'MANAGED COMPETITION.'"
After the war, Hoover promoted a new socioeconomic order by insisting that this technocratic vision of managed competition could be administered through federal agencies such as the Department of Commerce and the Federal Trade Commission (FTC).
Dormitory Energy Competition-A managed competition for energy reduction and behavior change among residents of several college houses, chosen for similarities of size, age, design and purpose.