Measuring Community Benefits Provided by Nonprofit and For-Profit HMOs

2003 ◽  
Vol 40 (2) ◽  
pp. 114-132 ◽  
Author(s):  
Mark Schlesinger ◽  
Shannon Mitchell ◽  
Bradford Gray
Keyword(s):  
Local Population ◽  
Health Maintenance Organizations ◽  
Future Research ◽  
Community Benefit ◽  
Health Maintenance ◽  
For Profit ◽  
Community Benefits ◽  
Comprehensive Comparison ◽  
Nationally Representative ◽  
Dramatic Shift

Despite the dramatic shift from nonprofit to for-profit ownership in the managed care industry, little is known about the implications for health plans' relations with the communities in which they operate. This paper provides the first comprehensive comparison of the community benefit activities of nonprofit and for-profit health maintenance organizations (HMOs). We develop a conceptual framework for identifying these activities and provide evidence from a nationally representative survey of plans fielded in 1999. We find that nonprofit plans exceed their for-profit counterparts on some, but not all, aspects of community benefit activity. The most consistent ownership-related differences involve redistributive programs (subsidized services and general philanthropy), commitments to medical research, and services that benefit the entire local population, beyond the plan's enrollees. Other forms of community benefits show mixed or modest differences between nonprofit and for-profit plans. Unexpectedly, for-profit plans actually appear more active in helping consumers deal with information asymmetries. The paper concludes with a discussion of implications for policy and future research.

Kaiser-Permanente: A Model American Health Maintenance Organization

1974 ◽  
Vol 4 (4) ◽  
pp. 599-615 ◽  
Author(s):  
Judith Carnoy ◽  
Linda Koo
Keyword(s):  
Cost Reduction ◽  
Health Maintenance Organization ◽  
Care Program ◽  
The United States ◽  
Health Maintenance Organizations ◽  
Kaiser Permanente ◽  
Health Maintenance ◽  
For Profit ◽  
Use Of Services ◽  
Private Corporations

The Kaiser-Permanente medical care program, a prepaid group practice that has been operating in California for over 30 years, is one of the most successful Health Maintenance Organizations (HMOs) in the United States. Kaiser's membership in California, Portland, Hawaii, Denver, and Cleveland exceeds 2.5 million. The main success that HMOs can claim is cost reduction. Kaiser can provide a package of services at lower cost than identical services would cost in “mainstream” medicine. The way in which an HMO reduces cost is by lowering the use of services by its members. Kaiser members spend half as many days in the hospital as a similar population of Blue Cross/Blue Shield subscribers. But Kaiser also tends to lower the availability of services that are not presently performed in excess. Ambulatory care is not easily accessible-large numbers of patients complain of waiting several weeks for appointments, of receiving rushed impersonal treatment, and of being unable to find and keep a personal physician. Thus Kaiser cost reduction goes hand-in-hand with a general inaccessibility of services. The reason for this is the working of the profit motive. Whether for-profit or technically “nonprofit,” private corporations have always committed themselves to maximizing their income, reducing their expenditures, and using the surplus for expansion. The profit incentive leads private HMOs to limit services by hiring an inadequate number of physicians and other personnel so that patients will be discouraged from seeking care. In this way, expenses go down and surplus goes up. This is a revision of an article, “Kaiser Plan,” that appeared in the Health-PAC Bulletin, No. 55, pp. 1-18, November 1973.

SEEKING TIES THAT BIND

PEDIATRICS ◽  
1995 ◽  
Vol 95 (5) ◽  
pp. 704-704
Keyword(s):  
Financial Risk ◽  
Medical Center ◽  
Health Maintenance Organizations ◽  
Health Maintenance ◽  
Physician Practices ◽  
Chief Operating Officer ◽  
For Profit ◽  
Long Run ◽  
Commercial Enterprise ◽  
Primary Care Practices

The efforts of academic centers to acquire primary care practices have set off many of the town-and-gown issues that have long provoked controversy between academe and community-based physicians. Nelson Ford, the chief operating officer of Georgetown University Medical Center, said: "Acquiring physician practices is a futile exercise in the long run, because you can't buy a doctor's mind. When you buy a practice, you may be buying somebody who wants to work less or wants the financial risk of the market chaos removed from his or her plate." One of the most vexing issues for academic centers creating provider networks is that of securing the capital to acquire practices without becoming a commercial enterprise largely oriented toward profit. (Ironically, the nation's ten largest health maintenance organizations, all but two of which are for-profit companies, are reported to have so much cash they don't know what to do with it.)

scholarly journals Hospital Advertising in California, 1991–1997

2002 ◽  
Vol 39 (3) ◽  
pp. 298-313 ◽  
Author(s):  
Robert J. Town ◽  
Imran Currim
Keyword(s):  
Health Maintenance Organizations ◽  
Market Concentration ◽  
Hospital Level ◽  
Health Maintenance ◽  
For Profit ◽  
Not For Profit ◽  
Level Information

This paper examines the advertising behavior of California hospitals from 1991 to 1997. Using highly detailed hospital-level information, we found that hospital advertising in California increased dramatically: annual spending on advertising grew (inflation adjusted) more than sixfold over the period. In addition, advertising expenditures varied significantly across hospitals. We found that hospital advertising increased with market concentration; with the number of nearby potential patients; with the percentage of nearby patients insured through Medicare, health maintenance organizations (HMOs), and indemnity insurance; and with chain affiliation. For-profit hospitals were not found to advertise more than their not-for-profit counterparts.

scholarly journals Not-for-profit hospitals’ provision of community benefit during the 2008 recession: An analysis of hospitals in Maryland

2013 ◽  
Vol 3 (3) ◽  
pp. 7
Author(s):  
Simone Rauscher Singh
Keyword(s):  
Burden Of Illness ◽  
Panel Regression ◽  
Charity Care ◽  
Community Benefit ◽  
For Profit ◽  
Community Benefits ◽  
Not For Profit ◽  
Difficult Time ◽  
Using Data ◽  
Charitable Activities

During the 2008 recession, many U.S. hospitals had to lay off staff and cut services to reduce costs, yet little is known about how these cuts affected hospitals’ provision of community benefits. While the need for charitable programs and services grew during this economically difficult time, financial pressures may have forced hospitals to cut back on their community benefit spending. Using data for not-for-profit hospitals in the state of Maryland for the years 2006 to 2010, this study explored whether, and if so how, hospitals changed their provision of community benefit during the 2008 recession. The findings showed that, on average, Maryland hospitals increased their charitable activities during the recent recession. Between 2006 and 2010, total spending on community benefits grew from an average of 5.6% to 7.7% of operating expenses with the most substantial growth in hospitals’ provision of charity care and mission-driven health services. Panel regression analysis showed that this increase in charitable activity was associated with increases in community need. Hospitals’ financial performance, on the other hand, was unrelated to their community benefit spending. These findings indicate that even in times of constrained budgets, Maryland hospitals provided substantial amounts of community benefit in response to the needs of the communities they serve. Hospital-based community benefit programs thus have the potential to play an important role in on-going community-wide efforts aimed at reducing the burden of illness and improving population health.  

The Effect of Physician and Corporate Interests on the Formation of Health Maintenance Organizations

1993 ◽  
Vol 99 (1) ◽  
pp. 164-200 ◽  
Author(s):  
Douglas R. Wholey ◽  
Jon B. Christianson ◽  
Susan M. Sanchez
Keyword(s):  
Health Maintenance Organizations ◽  
Health Maintenance ◽  
Corporate Interests

scholarly journals Workaholism in Korea: Prevalence and Socio-Demographic Differences

2020 ◽  
Vol 11 ◽  
Author(s):  
Sudol Kang
Keyword(s):  
Demographic Variables ◽  
Future Research ◽  
Demographic Differences ◽  
Research Directions ◽  
Confirmatory Factor Analyses ◽  
Work Addiction ◽  
Confirmatory Factor ◽  
Future Research Directions ◽  
Logistic Regressions ◽  
Nationally Representative

This study has two objectives – to provide a Korean form of the workaholism analysis questionnaire, and to analyze workaholic tendencies in South Korea by using a nationally representative data. Using 4,242 samples (2,497 men and 1,745 women), exploratory and confirmatory factor analyses were conducted to develop a Korean form (K-WAQ). The four-factor structure of K-WAQ in this study seemed to adequately represent the underlying dimensions of work addiction in Korea. The study also analyzed the prevalence of workaholism among Koreans and its differences according to socio-demographic variables. Both mean difference analyses and logistic regressions were conducted. The overall result indicated that the prevalence of workaholism in Korea can be estimated to be 39.7% of the employees. The workaholic tendencies in Korea differ significantly according to gender, age, work hours, and voluntariness of choosing employment type. Practical as well as theoretical implications and future research directions are discussed.

Sign in / Sign up

Export Citation Format

Share Document