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Managed competition using both market-driven and regulatory strategies.
1Health and Hospital Service, Asheville, NC, USA.
Managed Care Quarterly
|December 13, 2002
Summary
Managed competition healthcare models control costs but not service delivery. A proposed reform plan aims for universal access, defined benefits, and national expenditure caps with local resource allocation.
Area of Science:
- Health economics
- Healthcare policy
- Public health
Background:
- Market-driven managed competition has controlled healthcare cost increases through utilization and price management.
- However, this approach has not yet ensured effective and efficient health service delivery.
Purpose of the Study:
- To propose a health reform plan addressing the limitations of managed competition.
- To outline a system for universal healthcare access and defined benefits.
Main Methods:
- The proposed plan incorporates a national health expenditure ceiling.
- It advocates for local decision-makers to allocate resources.
- Existing insurers would administer the plan, offering quality of care comparisons.
Main Results:
- The plan aims to achieve universal access to basic health benefits.
- It includes options for supplementary benefits.
- It seeks to improve the efficiency and effectiveness of health service delivery.
Conclusions:
- The proposed reform integrates cost control with improved service delivery mechanisms.
- It emphasizes local resource allocation and consumer choice through quality comparisons.