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Stanford University's experience with managed competition.

Alain C Enthoven1, Brian Talbott

  • 1Graduate School of Business, Stanford University, Stanford, CA, USA. enthoven@stanford.edu

Health Affairs (Project Hope)
|November 13, 2004
PubMed
Summary

Stanford University

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Area of Science:

  • Health Economics
  • Health Services Research
  • Insurance Markets

Background:

  • Employer-sponsored health insurance is a significant component of employee compensation.
  • Rising healthcare costs and premiums present challenges for both employers and employees.
  • Managed competition models aim to leverage market forces to control costs and improve quality.

Purpose of the Study:

  • To describe Stanford University's managed competition health insurance model.
  • To analyze the impact of this model on employee choice and cost.
  • To discuss the conditions necessary for managed competition to transform healthcare delivery.

Main Methods:

  • Description of Stanford's "managed competition" health insurance plan.
  • Explanation of employee premium contribution and employer cost-sharing.
  • Details on risk adjustment mechanisms (age, sex, planned inclusion of prescription drug data).

Main Results:

  • Employees can select plans aligning with their preferences and willingness to pay.
  • All employees have access to a low-cost health insurance option.
  • Premiums have increased significantly over the past five years, mirroring market trends.

Conclusions:

  • Stanford's model offers employee choice and subsidized access to health insurance.
  • Risk adjustment is employed to manage costs based on employee demographics.
  • Widespread adoption of managed competition by regional employers is crucial for systemic transformation.

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