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Managed Competition (managed + competition)

Distribution by Scientific Domains
Medical Sciences100%

Selected Abstracts

Managed competition in the Netherlands: still work-in-progress

HEALTH ECONOMICS, Issue 3 2009
Wynand P. M. M. Van de Ven
No abstract is available for this article. [source]

The impact of managed competition on diversity, innovation and creativity in the delivery of home-care services

HEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 4 2008
Glen E. Randall PhDArticle first published online: 28 JUN 200
Abstract Reforming publicly funded healthcare systems by introducing elements of competition, often by allowing for-profit providers to compete with not-for-profit providers, is a strategy that has become commonplace in Western democracies. It is widely thought that the competitive forces of the marketplace will lead to greater efficiency, diversity and even innovation in the delivery of services. Between 1997 and 2000, a model of ,managed competition' was introduced as a major reform to the delivery of home-care services in Ontario, Canada. It was expected that by allowing greater competition within the home-care sector, this model would constrain costs and encourage provider agencies to become more innovative and creative in meeting service delivery needs. The purpose of this case study is to explore the impact of the managed competition reform on the for-profit and the not-for-profit organisations that provided rehabilitation home-care services, and, more specifically, to assess the extent to which the goal of greater diversity, innovation and creativity was achieved following implementation of the reform. A purposive sample of 49 key informants were selected for in-depth interviews, and a survey of the 36 organisations that provided rehabilitation home-care services and the 43 community care access centres that purchased services from these provider agencies was conducted. Data were collected between November 2002 and May 2003. Findings demonstrate that a combination of coercive, mimetic and normative isomorphic pressures have constrained diversity, innovation and creativity within the home-care sector. The implication is that the features that have traditionally distinguished for-profit and not-for-profit provider agencies from each other are rapidly disappearing, and a new hybrid organisational structure is evolving. [source]

The intention to switch health insurer and actual switching behaviour: are there differences between groups of people?

HEALTH EXPECTATIONS, Issue 2 2010
Michelle Hendriks PhD
Abstract Background, Several western countries have introduced managed competition in their health care system. In the Netherlands, a new health insurance law was introduced in January 2006 making it easier to switch health insurer each year. Objective, The objective was to measure people's intention to switch health insurer and actual switching behaviour. We also examined whether some groups were less inclined to switch health insurer and/or had more difficulty to exert their intention to switch. Design, In October 2006, members of three Dutch panels indicated whether they intended to switch health insurer during that year's open enrolment period. In the beginning of 2007, the same people were asked whether they indeed switched health insurer. Results, Only 1% intended to switch health insurer. Women, older people, lower educated people, people who were insured for a longer period and people who reported a bad or moderate health were less inclined to switch health insurer. The amount of switching was higher among individuals who intended to switch (31%) than among individuals who did not know whether they would switch (7%) and individuals with no intention to switch (2%). Among those who intended to switch health insurer, women and people who reported a good health switched health insurer more often. The years of enrolment were also associated with actual switching behaviour. Discussion and Conclusions, We might have to temper the optimistic expectations on enhanced choice. Future research should determine why people do not switch health insurer when they intend to and which barriers they experience. [source]

Tuberculosis control and managed competition in Colombia

INTERNATIONAL JOURNAL OF HEALTH PLANNING AND MANAGEMENT, Issue S1 2004
Maria Patricia Arbelaez
Abstract Law 100 introduced the Health Sector Reform in Colombia, a model of managed competition. This article addresses the effects of this model in terms of output and outcomes of TB control. Trends in main TB control indicators were analysed using secondary data sources, and 25 interviews were done with key informants from public and private insurers and provider institutions, and from the health directorate level. We found a deterioration in the performance of TB control: a decreasing number of BCG vaccine doses applied, a reduction in case finding and contacts identification, low cure rates and an increasing loss of follow up, which mainly affects poor people. Fragmentation occurred as the atomization and discontinuity of the technical processes took place, there was a lack of coordination, as well as a breakdown between individual and collective interventions, and the health information system began to disintegrate. The introduction of the Managed Competition (MC) in Colombia appeared to have adverse effects on TB control due to the dominance of the economic rationality in the health system and the weak state stewardship. Our recommendations are to restructure the reform's public health component, strengthen the technical capacity in public health of the state, mainly at the local and departmental levels, and to improve the health information system by reorienting its objectives to public health goals. Copyright © 2004 John Wiley & Sons, Ltd. [source]

The impact of managed competition on diversity, innovation and creativity in the delivery of home-care services

HEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 4 2008
Glen E. Randall PhDArticle first published online: 28 JUN 200
Abstract Reforming publicly funded healthcare systems by introducing elements of competition, often by allowing for-profit providers to compete with not-for-profit providers, is a strategy that has become commonplace in Western democracies. It is widely thought that the competitive forces of the marketplace will lead to greater efficiency, diversity and even innovation in the delivery of services. Between 1997 and 2000, a model of ,managed competition' was introduced as a major reform to the delivery of home-care services in Ontario, Canada. It was expected that by allowing greater competition within the home-care sector, this model would constrain costs and encourage provider agencies to become more innovative and creative in meeting service delivery needs. The purpose of this case study is to explore the impact of the managed competition reform on the for-profit and the not-for-profit organisations that provided rehabilitation home-care services, and, more specifically, to assess the extent to which the goal of greater diversity, innovation and creativity was achieved following implementation of the reform. A purposive sample of 49 key informants were selected for in-depth interviews, and a survey of the 36 organisations that provided rehabilitation home-care services and the 43 community care access centres that purchased services from these provider agencies was conducted. Data were collected between November 2002 and May 2003. Findings demonstrate that a combination of coercive, mimetic and normative isomorphic pressures have constrained diversity, innovation and creativity within the home-care sector. The implication is that the features that have traditionally distinguished for-profit and not-for-profit provider agencies from each other are rapidly disappearing, and a new hybrid organisational structure is evolving. [source]