scholarly journals Vertical Restraints and Powerful Health Insurers: Exclusionary Conduct Masquerading as Managed Care?

1988 ◽  
Vol 51 (2) ◽  
pp. 195 ◽  
Author(s):  
Frances H. Miller
Keyword(s):  
Managed Care ◽  
Vertical Restraints ◽  
Health Insurers

Managed Care and Financial Risks of Health Insurers Under PPACA

2015 ◽  
Author(s):  
Etti G. Baranoff ◽  
Thomas W. Sager ◽  
Bo Shi ◽  
Dalit Baranoff
Keyword(s):  
Managed Care ◽  
Financial Risks ◽  
Health Insurers

scholarly journals Insurer-Provider Networks in the Medical Care Market

2009 ◽  
Vol 99 (1) ◽  
pp. 393-430 ◽  
Author(s):  
Katherine Ho
Keyword(s):  
Managed Care ◽  
Medical Care ◽  
Profit Maximization ◽  
Investment Incentives ◽  
Hospital Mergers ◽  
Provider Networks ◽  
Hospital Networks ◽  
Care Health ◽  
Capacity Constrained ◽  
Health Insurers

I use data on the hospital networks offered by managed care health insurers to estimate the expected division of profits between insurers and providers. I include a simple profit-maximization framework and an additional effect: hospitals that can secure demand without contracting with all insurers (e.g., those most attractive to consumers and those that are capacity constrained) may demand high prices that some insurers refuse to pay. Hospital mergers may also affect price bargaining. I estimate that all three types of hospitals capture higher markups than other providers. These results provide information on the hospital investment incentives generated by bargaining. (JEL G22, G34, I11, L25)

scholarly journals Vertical Restraints Among Hospitals, Physicians and Health Insurers that Raise Rivals’ Costs

1988 ◽  
Vol 14 (2-3) ◽  
pp. 147-169
Author(s):  
Jonathan B. Baker
Keyword(s):  
District Court ◽  
Vertical Restraints ◽  
Antitrust Laws ◽  
Health Insurers

Two recent district court opinions consider whether affiliations among hospitals, doctors and health insurers — through contract or ownership — violate the antitrust laws. This Article applies a raising rivals’ costs framework to the facts of those cases in order to assess whether the practices at issue were unreasonable.

Management Issues: Ethics and Clinical Productivity Pressures Under Managed Care

1997 ◽  
Vol 7 (3) ◽  
pp. 8-10 ◽  
Author(s):  
Becky Sutherland-Cornett ◽  
Bernard P. Henri ◽  
Brooke Hallowell
Keyword(s):  
Managed Care ◽  
Management Issues

Manual Explains Autism Law to Health Insurers

ASHA Leader ◽  
2011 ◽  
Vol 16 (1) ◽  
pp. 19-19
Author(s):  
Carol Polovoy
Keyword(s):  
Health Insurers

Managed Care Rules Aim to Boost Medicaid Quality, Ease of Participation

ASHA Leader ◽  
2016 ◽  
Vol 21 (8) ◽  
pp. 24-25
Author(s):  
Havens Laurie Alban
Keyword(s):  
Managed Care
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