STATE REGULATION AND THE DEVELOPMENT OF LOCAL HMO MARKET

国家监管和当地 HMO 市场的发展

• 批准号: 3371848
• 负责人: DOUGLAS R WHOLEY
• 金额: $ 7.01万
• 依托单位: UNIVERSITY OF ARIZONA
• 依托单位国家: 美国
• 财政年份: 1989
• 资助国家: 美国
• 起止时间: 1989-05-01 至 1990-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3371848
• 关键词: health care model; health economics; health related legal; longitudinal human study; managed care

Health Maintenance Organizations (HMOs) are playing a significant part in the restructuring of health care delivery in the United States. As more and more HMOs have suffered financial losses, state governments have increased their regulatory oversight activities. The primary purpose of this study is to evaluate the effects of these state regulations and changes in them on the development and evolution of local HMO markets. Theoretical models from organizational sociology will be used to generate hypotheses concerning the effects of state regulations and community characteristics on HMO entries exists, and competitive interactions. These hypotheses will be tested by applying maximum likelihood techniques to estimate model parameters, using a longitudinal data set. The data set will contain MSA level information on individual HMO characteristics; HMO entries and exits; economic and sociodemographic characteristics; medical care system characteristics; and state laws relating to HMO formation and operations. Our analysis will address the following questions: Which state-level regulations and community characteristics, if any affect the entry of HMOs? How do these effects vary depending on type of HMO, (e.g., local vs. national sponsorship, prepaid group practice vs. individual practice association? Which state-level regulations and community characteristics, if any affect the exit of HMOs? How do these effects vary depending on the type of HMO? How do state regulations and community characteristics affect a local market's competitive structure, the mix of different types of HMOs in local markets, over time? By answering these questions, we will advance current knowledge of the structure and evolution of local HMO markets and provide valuable information for use by policymakers in carrying out state regulatory oversight of these markets.

健康维护组织（HMO）正在发挥重要作用 一部分在联合国重组医疗保健交付 国家。 随着越来越多的HMO遭受经济损失， 州政府增加了监管监督 活动。 这项研究的主要目的是评估 这些国家法规的影响以及它们的变化对 当地HMO市场的发展和发展。 理论模型 来自组织社会学将用于产生假设 关于国家法规和社区的影响 HMO条目的特征存在和竞争性 互动。 这些假设将通过施加最大 使用A 纵向数据集。 数据集将包含MSA级别 有关单个HMO特征的信息； HMO条目和 退出；经济和社会人口统计学特征；医疗 系统特征；和与HMO成立有关的州法律 和操作。 我们的分析将解决以下问题： 哪些州级法规和社区特征，如果有的话 影响HMO的进入？ 这些效果如何根据 HMO的类型（例如本地与国家赞助，预付费小组 实践与个人实践协会？ 哪些州级法规和社区特征，如果有的话 影响HMO的出口？ 这些效果如何根据 HMO的类型？ 国家法规和社区特征如何影响 当地市场的竞争结构，不同类型的组合 随着时间的推移，本地市场的HMO？ 通过回答这些问题，我们将提高当前的知识 本地HMO市场的结构和演变，并提供 有价值的信息供政策制定者在执行状态下使用 对这些市场的监管监督。