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

Publisher: Blackwell Country of Publication: United States NLM ID: 0053006 Publication Model: Print Cited Medium: Print ISSN: 0017-9124 (Print) Linking ISSN: 00179124 NLM ISO Abbreviation: Health Serv Res Subsets: MEDLINE

Publication: Malden, MA : Blackwell
Original Publication: Chicago, Hospital Research and Educational Trust.

Aid to Families with Dependent Children* ; Child Welfare* ; Managed Care Programs* ; Quality of Health Care*; Child Health Services/*standards ; Economic Competition/*economics; Adolescent ; Censuses ; Child ; Child Health Services/economics ; Child, Preschool ; Humans ; New York ; Quality Indicators, Health Care ; United States

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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Date Created: 20080506 Date Completed: 20080701 Latest Revision: 20211020

20250114

PMC2442245

10.1111/j.1475-6773.2007.00805.x

18454776