More than seven of 10 adults believe the U.S. health system needs fundamental change or complete rebuilding. Most adults surveyed reported difficulties accessing care, poor care coordination, and struggles with the costs and administrative hassles of health insurance. In addition, the survey finds substantial evidence of inefficient and wasteful delivery of health services. When looking toward ...

The needs of refugees and the struggles on the part of service providers to address this diverse population have received limited attention within the academic literature. This paper profiles Hauora o Puketapapa/Roskill Union and Community Health Centre (HoP), which is a non-profit, community owned and operated health clinic designed to deliver accessible, affordable and appropriate primary hea...

This paper is concerned with the pricing behaviour of providers of residential care for people with mental health problems. Two aspects of pricing were considered. First, are there differences between providers' market power and their actual mark-up rates (e.g. due to differences in motivation)? Second, do the different governance arrangements used in sectors of the industry, such as unified pu...

Professional Standards Review Organizations (PSRO's) came into being because of the need for our health care delivery system to provide high-quality care at reasonable cost to our country's citizens. All those involved in the system must bear a part of the responsibility for the failures of that system in the past. And, there is no doubt that while our health care system has had many successes,...

BACKGROUND Health departments often have little knowledge of HIV testing and linkage activities outside of those they directly fund. Many health departments also have limited access to outside academic expertise. METHODS We conducted a survey of health organizations in the Houston/Harris County region to determine the number of HIV tests completed in 2011, activities that organizations conduc...

The health care delivery system is changing rapidly, with providers forming patient-centered medical homes and exploring the creation of accountable care organizations. Enactment of the Affordable Care Act will likely accelerate these changes. Significant delivery system reforms will simultaneously affect the structures, capabilities, incentives, and outcomes of the delivery system. With so man...

The claim that managed care plans are more efficient than fee-for-service plans has been made so often that it has reached the status of folklore, but the evidence is inconclusive. The claim is usually based on one or both of the following errors: (1) lower medical care costs mean lower total costs (medical plus administrative costs) and (2) lower HMO premiums mean HMOs are more efficient than ...

OBJECTIVE To assess utilization of ambulatory visits to primary care physicians (PCPs) and to specialists in 2 different managed care models: a closed panel gatekeeper health maintenance organization (HMO) and an open panel point-of-service HMO. STUDY DESIGN Retrospective study of patients enrolled in a single managed care organization with 2 distinct product lines: a gatekeeper HMO and a poi...

Health care reform is directed toward improving access and quality while containing costs. An essential part of this is improvement of pricing models to more accurately reflect the costs of providing care. Transparent prices that reflect costs are necessary to signal information to consumers and producers. This information is central in a consumer-driven marketplace. The rapid increase in high ...

Health care providers offer an ideal setting to study the effectiveness of resilient behavior. The notion of a resilient organization is an emerging concept for understanding and coping with the modern-day pace of change and associated work stress. Resilience is the ability of an individual or organization to expeditiously design and implement positive adaptive behaviors matched to the immediat...