Wolfson G S, Talbert J C
University of Kentucky, USA.
J Health Hum Serv Adm. 2000 Winter;23(3):274-305.
In the thrust toward constructing economic value, health care provider firms have been consolidating at a marked rate. Medicaid managed care programs have been rapidly emerging with the objectives of containing health care costs and improving services for beneficiaries. However, there are concerns that the trend toward achieving market efficiency through merger is largely incongruent with the economic and health value objectives of Medicaid managed care programs in the states. Discordance among value objectives arises primarily because of inefficient and market concentrating horizontal merger strategies employed by firms and disruptions in quality of care that occur during the transition to integrated health care systems. By promoting vertical integration strategies and filling in the quality gaps created by an active merger environment, Medicaid offices advance state objectives of cost containment and quality while recognizing that providers operate in a complex and competitive environment that necessitates consolidation for organizational survival.
在构建经济价值的推动下，医疗服务提供商公司一直在以显著的速度进行合并。医疗补助管理式医疗计划迅速兴起，旨在控制医疗成本并改善受益人的服务。然而，有人担心通过合并实现市场效率的趋势在很大程度上与各州医疗补助管理式医疗计划的经济和健康价值目标不一致。价值目标之间的不一致主要源于公司采用的低效且导致市场集中的横向合并策略，以及向综合医疗系统过渡期间出现的医疗质量中断。通过推动纵向整合策略并填补活跃的合并环境所造成的质量差距，医疗补助办公室在认识到供应商在复杂且竞争激烈的环境中运营、为了组织生存需要进行合并的同时，推进了州政府控制成本和提高质量的目标。
