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MARKETWATCH
For-Profit And Not-For-Profit Health Plans Participating In Medicaid
Bruce E. Landon and
Arnold M. Epstein
The proliferation of for-profit health plans has heightened concerns about quality of care, particularly with respect to Medicaid. We undertook this study to compare for-profit and not-for-profit health plans that participate in Medicaid, examining processes of care and the organizational characteristics related to utilization management, financial incentives, and quality of care. Our findings demonstrate that for-profit and not-for-profit plans appear to be more similar than dissimilar in many areas of management, although for-profit plans are more likely to use aggressive utilization review and have slightly less developed quality management systems. On balance, these findings should reassure critics of for-profit health care.
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M. B. Rosenthal, B. E. Landon, S.-L. T. Normand, R. G. Frank, and A. M. Epstein
Pay for Performance in Commercial HMOs
N. Engl. J. Med.,
November 2, 2006;
355(18):
1895 - 1902.
[Abstract]
[Full Text]
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