title: Managed care and multilevel long-term care providers: reluctant partners.
abstract: Managed care is reshaping our health care system, although long-term care is only beginning to feel its effects. We report on the managed care involvement of 492 multilevel, long-term care facilities (MLFs; including skilled nursing and assisted/independent living) nationally. Organizational structure and culture and especially environmental characteristics are associated with whether facilities have contracts with managed care organizations (MCOs), plan to have contracts, are only gathering information on MCOs, or intend to do nothing in the near future. Resource dependence theory best explains MCO contracting patterns with MLFs appearing to be responding more to survival than to growth.
authors.affiliation: University of California at Los Angeles, School of Public Health and Borun Scholar 90095-1772, USA. swallace@ucla.edu
authors.forename: S P
authors.initials: SP
authors.lastname: Wallace
authors.forename: J
authors.initials: J
authors.lastname: Cohn
authors.forename: J
authors.initials: J
authors.lastname: Schnelle
authors.forename: R
authors.initials: R
authors.lastname: Kane
authors.forename: J G
authors.initials: JG
authors.lastname: Ouslander
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006707:Homes for the Aged / Q000458:organization & administration; D006801:Humans; D016015:Logistic Models; D008134:Long-Term Care / Q000458:organization & administration; D008329:Managed Care Programs / Q000639:trends*; D006278:Medicare; D015999:Multivariate Analysis; D009735:Nursing Homes / Q000458:organization & administration; D016017:Odds Ratio; D012866:Skilled Nursing Facilities / Q000458:organization & administration; D014481:United States