Publications

This paper analyzes the process and outcomes of collective negotiations among large private employers and health maintenance organizations (HMOs) in California.

The rate of increase in health care expenditures has been a central policy concern for well over a decade, yet little empirical research has been conducted to examine expenditure growth rates. This study analyzed health insurance premium growth rates for a selected sample of 95 insured groups over the period 1985 to 1992.

A critical unresolved health policy question is whether competition stimulated by managed care organizations can slow the rate of growth in health care expenditures. The researchers analyzed the competitive effects of health maintenance organizations (HMOs) on the growth in fee-for-service indemnity insurance premiums over the period 1985—1992 using premium data on 95 groups that had policies with a single, large, private insurance carrier.