Environmental and organizational correlates and motivations for provider-sponsored health plan ownership in the post-reform era.
Background: The 1980s to 1990s saw many health systems in the United States enter and exit the insurance market in the form of provider-sponsored health plans (PSHPs). Reforms and value-based reimbursement methods have stimulated health care organizations to reconsider PSHP as a logical strategy. Pu...
| Published in: | Health Care Management Review Vol. 47; no. 3; pp. 188 - 199 |
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| Main Authors: | , , , , , |
| Format: | research tables/charts Journal Article |
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Lippincott Williams & Wilkins
Jul-Sep2022
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=157099585&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 157099585 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03616274 HCM jtl: Health Care Management Review issn: 03616274 maglogo: N pubinfo: dt: Jul-Sep2022 vid: 47 iid: 3 pid: 5086 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 157099585 157099585 157099585 10.1097/HMR.0000000000000316 157099585 ppf: 188 ppct: 11 formats: tig: atl: Environmental and organizational correlates and motivations for provider-sponsored health plan ownership in the post-reform era. aug: au: Meese, Katherine A. Hearld, Larry R. O'Connor, Stephen J. Peterson, Mary Dale Carroll, Nathan W. Sen, Bisakha affil: Katherine A. Meese, PhD, Assistant Professor and Director of Wellness Research, Department of Health Services Administration, University of Alabama at Birmingham.. sug: subj: Provider-Sponsored Organizations Administration Organizational Culture Evaluation Motivation Health Care Reform Value-Based Health Care Health Facility Administration Health Insurance Exchanges Human Multimethod Studies United States Semi-Structured Interview Medicare Employment Status Geographic Factors Odds Ratio Purposive Sample Medicaid T-Tests Pearson's Correlation Coefficient Chi Square Test Multiple Logistic Regression Descriptive Statistics Reimbursement, Incentive ab: Background: The 1980s to 1990s saw many health systems in the United States enter and exit the insurance market in the form of provider-sponsored health plans (PSHPs). Reforms and value-based reimbursement methods have stimulated health care organizations to reconsider PSHP as a logical strategy. Purpose: The aim of this study was to examine market and organizational factors associated with PSHP ownership and motivations for engaging in PSHP after health care reforms. The resource dependence theory was used as a theoretical lens. Methodology/Approach: A sequential quantitative to qualitative mixed-methods design was used. The quantitative analysis examined data for 5,849 U.S. hospitals. Results were synthesized with qualitative findings from 10 semistructured interviews representing eight health systems in five states. Results: Organizational and environmental characteristics were significantly associated with PSHP ownership. Hospital and payer concentration, Medicare penetration, income, unemployment rate, government, and for-profit and metro area hospitals were associated with a lower likelihood of PSHP ownership. Salaried physician arrangements, clinically integrated network membership and adoption of other risk-bearing arrangements were associated with higher odds of PSHP ownership. Interviewees described PSHP as the culmination of the journey to value-based care and as a strategy to improve patient care, compete, and diversify revenue streams. Conclusions: Both market and organizational factors are important considerations for hospitals contemplating PSHP ownership, and motivations for ownership cover a broad range of financial, competitive, strategic, and mission-based goals. Practice Implications: Hospitals considering PSHP ownership must carefully evaluate their competitive landscapes and organizational resources to ensure optimal conditions for this strategy. PSHP ownership has high start-up costs and requires a long-term organizational commitment. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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