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An analysis of health risk selection...

Salisbury, John Arnold.

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An analysis of health risk selection and quality of care under Medicare fee-for-service and Medicare managed care health care systems.

Record Type:	Electronic resources : Monograph/item
Title/Author:	An analysis of health risk selection and quality of care under Medicare fee-for-service and Medicare managed care health care systems./
Author:	Salisbury, John Arnold.
Description:	177 p.
Notes:	Source: Dissertation Abstracts International, Volume: 64-09, Section: B, page: 4269.
Contained By:	Dissertation Abstracts International64-09B.
Subject:	Health Sciences, Health Care Management. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3103964
ISBN:	0496515323

An analysis of health risk selection and quality of care under Medicare fee-for-service and Medicare managed care health care systems.
Salisbury, John Arnold.

An analysis of health risk selection and quality of care under Medicare fee-for-service and Medicare managed care health care systems. - 177 p.

Source: Dissertation Abstracts International, Volume: 64-09, Section: B, page: 4269.

Thesis (D.P.A.)--University of Southern California, 2003.

Managed health care is increasingly important to provision of health care services to Medicare and other public health insurance agencies. This study compares risk selection and quality of care between Fee-for-Service (FFS) and managed care organizations (MCO) in a mature managed health care market. A random sample, population based instrument---the 1997 Los Angeles County Health Survey---was used to explore these issues.

ISBN: 0496515323Subjects--Topical Terms:

1017922
Health Sciences, Health Care Management.

An analysis of health risk selection and quality of care under Medicare fee-for-service and Medicare managed care health care systems.
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100 1 $a Salisbury, John Arnold. $3 1925773
245 1 3 $a An analysis of health risk selection and quality of care under Medicare fee-for-service and Medicare managed care health care systems.
300 $a 177 p.
500 $a Source: Dissertation Abstracts International, Volume: 64-09, Section: B, page: 4269.
500 $a Adviser: Robert C. Myrtle.
502 $a Thesis (D.P.A.)--University of Southern California, 2003.
520 $a Managed health care is increasingly important to provision of health care services to Medicare and other public health insurance agencies. This study compares risk selection and quality of care between Fee-for-Service (FFS) and managed care organizations (MCO) in a mature managed health care market. A random sample, population based instrument---the 1997 Los Angeles County Health Survey---was used to explore these issues.
520 $a Risk selection was investigated using self-reported health status, chronic conditions, hospital admission, and regular source of care. Quality of care was investigated using access to services, waiting time for appointments, number of doctors' visits, and patient satisfaction.
520 $a Previous research had shown significant differences between FFS and MCO for both risk factors and quality of care issues. The present study predicts no significant difference for risk factors, quality of care, or access variables. This prediction is based on the Welch's (1984) theory of regression toward the mean. This assumes that, within a mature managed care market, Medicare beneficiaries will have aged into, as well as aged within the managed care system, thereby washing out any initial effects of favorable risk selection from the 1980's and early 1990's.
520 $a Results of this study support the hypothesis of no significant differences between MCO and FFS for health risk factors. No significant difference was found for self reported health status, chronic conditions, hospital admissions and regular source of care. Regarding the quality of care variables findings for only one variable, patient satisfaction, showed significant differences between FFS and MCOs.
520 $a This study's findings of few significant differences between FFS and MCOs within the Medicare population for health risk and healthcare issues indicate that Medicare's foray into managed healthcare may be yielding the quality of care, beneficiary access and cost savings that was intended. Significant issues for both MCO and FFS systems regarding prescription medications and routine cancer screening did emerge in the analysis of the findings.
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