Selective contracting for tertiary care services by managed care plans
The Foundation's Changes in Health Care Financing and Organization program was designed to support research, demonstration, and evaluation projects examining major changes in health care financing.The purpose of this project is to evaluate managed care plans' use of selective contracting to purchase tertiary care services. The grantee will describe the current state of selective contracting for tertiary care services by managed care organizations; assess the impact of characteristics of managed care plans, hospitals, and health care services; examine the extent to which managed care plans channel their tertiary care patients to particular hospitals in response to price concessions; and evaluate the broader market effect of managed care penetration on the use, cost, concentration, and quality of tertiary care services provided to populations in different geographic areas. The grantee will conduct a survey of managed plans in eleven states to identify and describe the extent and nature of plans' selective contracting for specific tertiary care services. They will then conduct statistical analyses of the factors that influence the establishment and terms of such contracts, estimate the plans' demand function for tertiary care services from individual hospitals, and analyze the effects of managed care penetration and selective contracting on a variety of outcome measures to assess the success of selective contracting.
Amount Awarded $554,006.00
Awarded on: 6/15/1994
Time frame: 7/1/1994 - 12/31/1997
Grant Number: 24328