Center for Studying Health System Change

Providing Insights that Contribute to Better Health Policy

Advanced Search Instructions

You can refine your search with the following modifiers:

* Use an to perform a wildcard search.Example: prescript* would return "prescription", "prescriptions" etc.
"" Use quotes to match a phrase.Example: "prescription drug" only returns results where the words are next to each other.
+ Use a plus sign to perform a search where the additional term MUST be part of the page.Example: prescription +drug
- Use a minus sign to perform a search where the additional term SHOULD NOT be part of the page.Example: prescription -drug
< > Use a < > sign to perform a search where the additional term should be of greater or lesser importance in the search.Example: prescription >drug
Find pages with the word precription with additional importance for the word drug.
( ) Use parentheses to group different search terms together.Example: prescription (+medicare -drug)
 

Insurance Coverage & Costs Access to Care Quality & Care Delivery Health Care Markets Employers/Consumers Health Plans Hospitals Physicians Issue Briefs Data Bulletins Research Briefs Policy Analyses Community Reports Journal Articles Other Publications Surveys Site Visits Design and Methods Data Files


Rate Setting and Health Maintenance Organizations

Fall 1996
Journal of Health Politics, Policy and Law, vol.21, no.3 (Fall 1996): 511-513
Paul B. Ginsburg

insburg comments on the work of Wallack, Skwara and Cai on the compatibility of competition and regulation in health care. They offer sound arguments that some design elements of rate-setting systems are more compatible with competition than others. Ginsburg however, argues against making regulated payment rates applicable to HMOs because the plans do not need a regulatory ceiling on prices, and making payment units mandatory risks interfering with HMOs’ use of financial incentives to influence the use of physicians services, particularly specialists. Incentives include fee-for-service payment, withholding partial payment and allocation of bonuses. These payment methods are continually evolving and are considered a key element of managed care.

For a full copy please visit Journal of Health Policy, Politics and Law. (Subscription required.)

 

Back to Top