Upon initial examination, efforts toward achieving these 2 goals appear philosophically complementary. For example, both tout as a primary benefit improvement of access to health care services. However, closer inspection of these initiatives' more prominent features reveals seemingly irreconcilable demands. As described below, the push toward consumer-driven health plans as a way to offer affor...

This article examines the possibilities for health care reform in the 111th Congress. It uses a simple model of policy making to analyze the failure of Congress to pass the Clinton health plan in 1993-1994. It concludes that the factors that created gridlock in the 103rd Congress are likely to have a similar impact in the present.

The objective of this study was to observe trends in payer expenditures for plan members with one of 14 chronic, complex conditions comparing one group with a disease management program specific to their condition (the intervention group) and the other with no specific disease management program (the control group) for these conditions. The authors used payer claims and membership data to ident...

n announcing his health reform plan on September 22, 1993, President Bill Clinton spoke of six overarching principles: securi ty , savings, qual i ty , implicity, choice, and responsibility. You can be sure that all these key words have tested well in polling and focus groups. Throughout the coming months, political language will be critical in shaping the debate. Since healthcare reform is suc...

OBJECTIVE To explore the implications of current approaches used by health plans and purchasers to identify preferred hospitals for tiered networks using cost and quality information. DATA SOURCES/STUDY SETTING 2002 secondary data from WebMD Quality Services on hospital quality and costs in five markets (Boston, Miami, Phoenix, Seattle, and Syracuse). STUDY DESIGN We compared four alternati...

KEY FINDINGS (1) Primary care physicians spent significantly more time on administrative tasks than did medical specialists or surgical specialists. (2) All staff in physician practices with one or two physicians spent more time on administrative tasks than did physicians and staff in practices with more than 10 physicians. (3) More than 75 percent of physicians and administrators reported that...