Posting date: September 7, 2005
This Article
* Reprint (PDF)
* HTML Version
* Submit a response to this article
* Comments: View responses
* Alert me when this article is cited
* Alert me when Comments are posted
* Alert me if a correction is posted
Services
* E-mail this article to a friend
* Similar articles in this journal
* Similar articles in PubMed
* Alert me to new issues of the journal
* Add to My Personal Archive
* Download to Citation Manager
*Reprints & Permissions
Citing Articles
* Citing Articles via HighWire
* Citing Articles via Google Scholar
Google Scholar
* Articles by Enthoven, A. C.
* Articles by Tollen, L. A.
* Search for Related Content
PubMed
* PubMed Citation
* Articles by Enthoven, A. C.
* Articles by Tollen, L. A.
Related Collections
* Health Reform
* Insurance - Employer-Based System
* Managed Care
* Managed Care - Consumers
* Managed Competition
* Business Of Health
* Health Spending
* Insurance Market
Health Affairs, 10.1377/hlthaff.w5.420
Copyright © 2005 by Project HOPE


Web Exclusives

Competition In Health Care: It Takes Systems To Pursue Quality And Efficiency

Alain C. Enthoven 1* Laura A. Tollen 2

1 Alain Enthoven is the Marriner S. Eccles Professor of Public and Private Management, Emeritus, at the Stanford University Graduate School of Business in Stanford, California.
2 Laura Tollen is a senior policy consultant at the Kaiser Permanente Institute for Health Policy in Oakland, California.

*Corresponding author.

  Abstract

Many stakeholders agree that the current model of U.S. health care competition is not working. Costs continue to rise at double-digit rates, and quality is far from optimal. One proposal for fixing health care markets is to eliminate provider networks and encourage informed, financially responsible consumers to choose the best provider for each condition. We argue that this "solution" will lead our health care markets toward even greater fragmentation and lack of coordination in the delivery system. Instead, we need markets that encourage integrated delivery systems, with incentives for teams of professionals to provide coordinated, efficient, evidence-based care, supported by state-of-the-art information technology.

Key Words: Business Of Health, Health Reform, Insurance - Employer-Based System, Managed Care, Managed Care - Consumers, Managed Competition, Health Spending, Insurance Market


Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati    What's this?


This article has been cited by other articles:


Home page
JAMAHome page
D. J. Nyweide, W. B. Weeks, D. J. Gottlieb, L. P. Casalino, and E. S. Fisher
Relationship of Primary Care Physicians' Patient Caseload With Measurement of Quality and Cost Performance
JAMA, December 9, 2009; 302(22): 2444 - 2450.
[Abstract] [Full Text] [PDF]


Home page
Health Aff (Millwood)Home page
J. Corrigan and D. McNeill
Building Organizational Capacity: A Cornerstone Of Health System Reform
Health Aff., March 1, 2009; 28(2): w205 - w215.
[Abstract] [Full Text] [PDF]


Home page
Health Aff (Millwood)Home page
W. Yip and W. C. Hsiao
The Chinese Health System At A Crossroads
Health Aff., March 1, 2008; 27(2): 460 - 468.
[Abstract] [Full Text] [PDF]


Home page
ANN INTERN MEDHome page
A. Mehrotra, A. M. Epstein, and M. B. Rosenthal
Do Integrated Medical Groups Provide Higher-Quality Medical Care than Individual Practice Associations?
Ann Intern Med, December 5, 2006; 145(11): 826 - 833.
[Abstract] [Full Text] [PDF]

Comments:

Read all Comments

Innovations in Systemness
Mark C. Shields
Health Affairs, 16 Sep 2005 [Full text]