title: Selective contracting in California: an update.
abstract: Six years of selective contracting for health services in California provide strong evidence that the policy works to depress inflation in hospital inpatient costs and revenues, shift inpatient care to outpatient settings, and spread the PPO health benefit option throughout the state. These responses occur against a backdrop of rapid increases in population and aging and continuing declines in inpatient utilization. The policy has yet to affect excess capacity or capital expansion, and possibly even encourages the latter. There is still no good evidence of effects on quality of care, nor, due to a number of new negative influences, is there likely to be.
authors.forename: L
authors.initials: L
authors.lastname: Johns
mesh_terms: D000553:Ambulatory Care / Q000706:statistics & numerical data; D002140:California; D002201:Capital Expenditures / Q000639:trends; D003284:Contract Services / Q000458:organization & administration*; D003363:Cost Control / Q000379:methods; D004469:Economics, Hospital / Q000639:trends*; D005376:Financial Management / Q000458:organization & administration*; D006761:Hospitals / Q000706:statistics & numerical data*; D008484:Medicaid / Q000458:organization & administration*; D011243:Preferred Provider Organizations / Q000706:statistics & numerical data; D015397:Program Evaluation; D013223:Statistics as Topic; D014481:United States