Regulating managed care plans: is the telecommunications industry a possible model?
Merger mania has been a striking trend in the health and managed care fields during the last decade, promising to improve integration of services, decrease excess capacity, enhance price competition, and increase the ability of providers and insurers to handle risk-based payment. In view of these promises, our first argument in this paper is that undoubtedly strong, well-financed managed care plans and health networks will continue to utilize the merger concept to acquire additional insurers and providers, eventually gaining more control over the organization and the financing of a region's health care delivery system. Our second thesis is that the quasicompetitive, quasiregulatory authority inherent in the Telecommunications Act of 1996, somewhat similar in concept to the American Hospital Association's earlier Ameriplan (1970), might serve as an appropriate model for Congress to use in designing future managed care, health field, and federal/state governmental interrelationships.
Jorgensen
N E
NE
Bedford Health Association, Inc., Asheville, NC, USA.
Weil
T P
TP
D000573:American Hospital Association; D004465:Economic Competition / Q000331:legislation & jurisprudence; D005161:Facility Regulation and Control / Q000331:legislation & jurisprudence*; D006273:Health Facility Merger / Q000331:legislation & jurisprudence*; D006279:Health Maintenance Organizations / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D007221:Industry / Q000331:legislation & jurisprudence; D017146:Models, Organizational; D009935:Organizational Affiliation; D013685:Telecommunications / Q000331:legislation & jurisprudence / Q000458:organization & administration; D014481:United States