Zwanziger J, Melnick G A, Bamezai A
University of Rochester.
Health Aff (Millwood). 1994 Fall;13(4):118-26. doi: 10.1377/hlthaff.13.4.118.
Critics of health care reform proposals that incorporate managed competition contend that it has never been broadly implemented. However, insurance plans that combine insurance with the provision of care have been widely implemented and have been tested most extensively in California. This DataWatch explores California's experience with health maintenance organizations (HMOs) and preferred provider organizations (PPOs), the introduction of which was followed by overall reductions in hospital costs. These reductions were larger in competitive markets. If implemented on a national scale, such selective contracting could be expected to reduce the growth of hospital costs even more rapidly than occurred in California.
对纳入管理竞争的医疗保健改革提案持批评态度的人认为，这种模式从未得到广泛实施。然而，将保险与医疗服务提供相结合的保险计划已得到广泛实施，并且在加利福尼亚州进行了最广泛的测试。本《数据观察》探讨了加利福尼亚州健康维护组织（HMO）和优选提供者组织（PPO）的经验，这些组织的引入之后，医院成本总体有所降低。在竞争激烈的市场中，这些降幅更大。如果在全国范围内实施，这种选择性签约有望比在加利福尼亚州更迅速地降低医院成本的增长。
