Home > Publications . Search All . Browse All . Country . Browse PSC Pubs . PSC Report Series

PSC In The News

RSS Feed icon

Work by Bailey and Dynarski cited in NYT piece on income inequality

Pfeffer says housing bubble masked decade-long growth in household net worth inequality

House, Burgard, Schoeni et al find that unemployment and recession have contrasting effects on mortality risk

Highlights

Jeff Morenoff makes Reuters' Highly Cited Researchers list for 2014

Susan Murphy named Distinguished University Professor

Sarah Burgard and former PSC trainee Jennifer Ailshire win ASA award for paper

James Jackson to be appointed to NSF's National Science Board

Next Brown Bag


PSC Brown Bags will return in the fall

Competition and health plan performance: Evidence from health maintenance organization insurance markets

Archived Abstract of Former PSC Researcher

Scanlon, D.P., Shailender Swaminathan, Michael Chernew, J.E. Bost, and J. Shevlock. 2005. "Competition and health plan performance: Evidence from health maintenance organization insurance markets." Medical Care, 43(4): 338-346.

Objective: We sought to assess whether health maintenance organizations (HMOs) operating in competitive markets, or markets with substantial HMO penetration, perform better on the standardized Health Plan Employer Data and Information Set (HEDIS) and Consumer Assessment of Health Plans Survey (CAHPS) measures. Study Design: We performed a secondary analysis of nonexperimental, cross-sectional data.

Data Sources: Data were obtained from a variety of sources, including the National Committee for Quality Assurance (NCQA), Interstudy, the Area Resource File, the U.S. Office of Personnel Management, and the U.S. Department of Labor.

Methods: Multiple Indicator Multiple Cause models were used to simultaneously estimate 6 latent quality variables from 35 HEDIS and CAHPS measures and to relate these latent variables to HMO competition and HMO penetration while controlling for other health, plan and market characteristics.

Principal Findings: Greater competition, as measured by the Herfindahl index, was associated with inferior health plan performance on 3 of 6 quality dimensions. Plans in markets with greater HMO penetration perform better on HEDIS- but not CAHPS-based dimensions of performance. Plans that make their data available publicly perform significantly better on both the HEDIS and CAHPS domains, performing one third to three quarters of a standard deviation better than plans that don't make their results available publicly.

Conclusions: Plans in more competitive markets in 1999 did not achieve better quality after controlling for other important covariates, although plans in markets with a high degree of HMO penetration are performing better on the HEDIS quality dimensions. Although our study design cannot determine causality, the results suggest reason to revisit the belief that competition among HMOs will inherently improve quality.

Country of focus: United States.

Browse | Search : All Pubs | Next