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. 2008 Jun;43(3):971-87.
doi: 10.1111/j.1475-6773.2007.00805.x.

Nonprice competition and quality of care in managed care: the New York SCHIP market

Hangsheng Liu  1 , Charles E Phelps
Affiliations

Nonprice competition and quality of care in managed care: the New York SCHIP market

Hangsheng Liu et al. Health Serv Res. 2008 Jun.

Abstract

Objective: To examine the effect of nonprice competition among managed care plans on the quality of care in the New York SCHIP market.

Data sources: U.S. Census 2000; 2002 New York State Managed Care Plan Performance Report; and 2001 New York State Managed Care Annual Enrollment Report.

Study design: Each market is defined as a county, and competition is measured as the number of plans in a market. Quality of care is measured in percentages using three Consumer Assessment of Health Plans Survey and three Health Plan Employer Data and Information Set scores. Two-stage least squares is applied to address the endogeneity between competition and the quality of care, using population as an instrument.

Principal findings: We find a negative association between competition and quality of care. An additional managed care plan is significantly associated with a decrease of 0.40-2.31 percentage points in four out of six quality measures. After adjusting for production cost, a positive correlation is observed between price and quality measures across different pricing regions.

Conclusions: It seems likely that pricing policy is a constraint on quality production, although it may not be interpreted as a causal relationship and further study is needed.

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Figures

Figure 1
Figure 1
Price Control and Quality of Care.
See this image and copyright information in PMC

References

    1. Agency of Healthcare Research and Quality (AHRQ) “National Health Quality Report”. 2003. [December 3, 2005]. Available at http://www.qualitytools.ahrq.gov/qualityreport/archive/2003/download/doc....
    1. Beaulieu N D. Quality Information and Consumer Health Plan Choices. Journal of Health Economics. 2002;21(1):43–63. - PubMed
    1. Cutler D M. The Incidence of Adverse Medical Outcomes under Prospective Payment. Econometrica. 1995;63(1):29–50.
    1. Dranove D, Shanley M, Simon C. Is Hospital Competition Wasteful? RAND Journal of Economics. 1992;23(2):247–62. - PubMed
    1. Farley D O, Short P F, Elliott M N, Kanouse D E, Brown J A, Hays R D. Effects of CAHPS Health Plan Performance Information on Plan Choices by New Jersey Medicaid Beneficiaries. Health Services Research. 2002a;37(4):985–1007. - PMC - PubMed