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How successfully can academic faculty practices compete in developing managed care markets?
1School of Public and Environmental Affairs, Indiana University, Indianapolis 46202, USA.
Summary
Academic medical centers can negotiate with managed care plans in developing markets. However, faculty practices must restructure internally to adapt to managed care, addressing concerns about resource utilization and practice patterns.
Area of Science:
- Health Services Research
- Healthcare Management
- Academic Medicine
Background:
- Academic faculty practices operate in evolving healthcare markets.
- Managed care plans are increasingly influential in healthcare delivery.
- Understanding the competitive landscape for academic practices is crucial.
Purpose of the Study:
- To investigate competitive options for academic faculty practices in markets with limited managed care.
- To assess the attractiveness of faculty practices for managed care contracting from both practice and payer perspectives.
- To identify key attributes influencing contract negotiations.
Main Methods:
- Qualitative study using personal and telephone interviews.
- Examined two specific healthcare markets (Philadelphia and Atlanta) in 1994.
- Utilized eight predefined attributes to evaluate faculty practice attractiveness.
Main Results:
- Academic medical center image is a significant asset for faculty practices.
- Concerns exist regarding utilization management and resource use within academic practices.
- Cultural differences in practice patterns between managed care and academic physicians were noted.
Conclusions:
- Opportunities exist for faculty practices to engage with managed care in developing markets.
- Internal restructuring is essential for faculty practices to succeed in a managed care environment.
- Addressing resource management and practice pattern differences is key for successful negotiation.