Americans are experienced at fixing blame when things go wrong. Our political system lets us throw out the leaders whose lack of judgment, skill, or honesty seems to have been the cause. Our legal system lets us sue individuals or corporations perceived to have been at fault. Although it does...

The previous decade witnessed a consumer “backlash” against cost-reducing models of health insurance that restrict consumers' decision rights and choices. In this paper I test the hypothesis that consumers' positive valuation of provider choice lead to a flight from HMO enrollments in the...

The paper investigates the US experience of Managed Care. It describes the cost controlling measures and the new modes of payment that were implemented along with managed Care. Using theory and field surveys, it reviews how these measures have affected physician practices. The paper also...

Managed care penetration has been partly responsible for slowing down increases in health care costs in recent years. This study uses a 1992–1996 Health Care Utilization Project sample of hospitals to analyze the relationship between managed care penetration in local insurance markets and...

This paper examines the evolution of average productivity among HMOs for 4,419 Health Maintenance Organizations (HMOs) from 1985 to 2001. For both IPA and non-IPA HMOs, HMO productivity increased from 1990 to 1996 and rapidly decreased from 1997 to 2001. In contrast to cost functions that show...

We applied a battery of cointegration tests comprising those of Johansen and Juselius [19], Phillips and Hansen [35], and Engle and Granger [6], to model aggregate health care expenditure using 1960–96 US data. The existence of a stable long-run economic relationship or cointegration is...

We extend prior research on the effect of managed care on the receipt of four medical interventions for pregnant women: ultrasound, induction/stimulation of birth, electronic fetal monitor, and cesarean delivery. Propensity score methods are used to account for sample selection issues regarding...

This primer aims to provide IMF macroeconomists with the essential information they need in situations where they must address issues concerning health sector policy and when they have significant macroeconomic implications. Such issues can also affect equity and growth and are fundamental to...

In the late 1980s, the Prospective Payment System and the expansion of managed care plans forced hospitals to be cost efficient. The increased number of hospital mergers suggests that merging is a way to become more efficient to ensure long-run survival. This study presents an economic framework...