“任何愿意提供服务的机构”和“选择自由”相关法律会影响健康维护组织（HMO）的市场份额吗？

Do "any willing provider" and "freedom of choice" laws affect HMO market share?

作者信息

Morrisey Michael A, Ohsfeldt Robert L

机构信息

Lister Hill Center for Health Policy, University of Alabama at Birmingham, 35294-0022, USA.

出版信息

Inquiry. 2003 Winter;40(4):362-74. doi: 10.5034/inquiryjrnl_40.4.362.

DOI:10.5034/inquiryjrnl_40.4.362

PMID:15055835

Abstract

This study examines the effects of "any willing provider" (AWP) and "freedom of choice" (FOC) laws on the market share of health maintenance organizations (HMOs) in metropolitan statistical areas over the period 1989-95. We use pooled cross-section time-series regression techniques with year and state fixed effects. HMO market share is hypothesized to be a function of state laws, market characteristics, and state preference for managed care regulation. AWP and FOC laws are characterized by three alternative measures of regulatory intensity. The results suggest that FOC laws have a greater impact on market share than do AWP laws. More comprehensive regulation has a bigger impact than less encompassing laws, and laws limiting selective contracting with physicians are more effective in reducing HMO market share than are laws covering hospitals or pharmacies.

摘要

本研究考察了“任何愿意提供者”（AWP）法和“选择自由”（FOC）法在1989 - 1995年期间对大都市统计区健康维护组织（HMO）市场份额的影响。我们运用了带有年份和州固定效应的混合横截面时间序列回归技术。HMO市场份额被假定为州法律、市场特征以及州对管理式医疗监管偏好的函数。AWP法和FOC法由三种监管强度的替代度量来表征。结果表明，FOC法对市场份额的影响比AWP法更大。更全面的监管比涵盖范围较小的法律影响更大，并且限制与医生进行选择性签约的法律在降低HMO市场份额方面比涵盖医院或药房的法律更有效。