Wholey D, Feldman R, Christianson J B, Engberg J
Department of Social and Decision Sciences, Carnegie-Mellon University, Pittsburgh, PA 15213, USA.
J Health Econ. 1996 Dec;15(6):657-84. doi: 10.1016/s0167-6296(96)00499-7.
We examine scale and scope economics among Group and IPA Health Maintenance Organizations (HMOs) over the period 1988 to 1991 using a national sample of HMOs. We allow for the multiproduct nature of HMO production by estimating the cost of producing a member month of non-Medicare and Medicare coverage, and we examine the effect of HMO market structure on costs. We find that HMOs benefit from scale economies. There are scope diseconomies associated with providing both non-Medicare and Medicare products. Group HMOs in more competitive markets have lower costs but IPA costs are not affected by competition.
我们使用健康维护组织（HMO）的全国样本，研究了1988年至1991年期间集团型和独立执业协会型健康维护组织（HMO）的规模经济和范围经济。我们通过估算生产一个非医疗保险和医疗保险覆盖成员月的成本，来考虑HMO生产的多产品性质，并研究HMO市场结构对成本的影响。我们发现HMO从规模经济中受益。提供非医疗保险和医疗保险产品存在范围不经济。处于竞争更激烈市场中的集团型HMO成本较低，但独立执业协会型HMO的成本不受竞争影响。
