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

PSC In The News

RSS Feed icon

Do universities need more conservative thinkers?

Geronimus says black-white differences in mortality "help silence black voices in the electorate"

Starr critical of risk assessment scores for sentencing

Highlights

Presentation on multilevel modeling using Stata, July 26th, noon, 6050 ISR

Frey's new report explores how the changing US electorate could shape the next 5 presidential elections, 2016 to 2032

U-M's Data Science Initiative offers expanded consulting services via CSCAR

Elizabeth Bruch promoted to Associate Professor

Next Brown Bag

PSC Brown Bags
will resume fall 2016

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 of America.

Browse | Search : All Pubs | Next