Grantee Publication

BACKGROUND: The researchers wanted to examine how membership in a health maintenance organization (HMO) is related to delivery of preventive clinical services to patients with different educational levels.

OBJECTIVE: To examine the impact of provider continuity on preventive care among adults who have a regular site of care.

DESIGN: Logistic regression analyses were conducted to explore whether continuity, categorized as having no regular care, site continuity, or provider continuity, was associated with receipt of 3 preventive care services (influenza vaccination, receipt of a mammogram, and smoking cessation advice), independent of predisposing, need, and enabling factors.

In this article, the researchers describe findings from their evaluation of the first four years’ experience of the Individual Health Coverage Program.

BACKGROUND: We explored the relationships between advice from a physician to quit smoking and an array of respondents' characteristics, including sociodemographic factors, health status, health insurance status, physician continuity, and intensity of smoking.

At national and state levels, there have been significant changes in the regulations governing individual and small group health insurance markets. Reforms to the individual health insurance market in New Jersey exemplify the challenges of informing consumers about changes in the regulation of insurers, where the changes are intended to simplify and broaden access to health insurance.

This study addresses two questions: (1) Does privatization affect the amount of un-compensated care provided by public hospitals? (2) Does privatization to nonprofit status have a different impact on the provision of uncompensated care than does privatization to for-profit status?

Read full article [18].

This paper reports findings from what is to date the most systematic investigation of both the short- and long-term community impacts of nonprofit hospital conversions. We found that conversions do not, on average, have an appreciable impact on community benefits.

Read full article [22].

OBJECTIVE: To describe the growth of any willing provider (AWP) and freedom of choice (FOC) laws applicable to managed care firms and to explore empirically the determinants of their enactment.

STUDY SETTING: A 1996 compendium of state laws and state-level data from the 1991-1994 period.

This paper empirically examines the relationship between HMO market share and the diffusion of magnetic resonance imaging (MRI) equipment. Across markets, increases in HMO market share are associated with slower diffusion of MRI into hospitals between 1983 and 1993, and with substantially lower overall MRI availability in the mid- and later 1990s. High managed care areas also had markedly lower rates of MRI procedure use.

A growing body of evidence suggests that managed care can reduce overall health care costs but provides little insight into how this could happen. One possibility is that managed care influences the adoption of new medical technologies. In examining the relationship between health maintenance organization (HMO) activity and market-level availability and use of magnetic resonance imaging (MRI), we find that high HMO market share is associated with low levels of MRI availability and use.