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Biomedical subjects

J E Kralewski

Publications and source records attributed to J E Kralewski.

At least 19 recordsLinked to original sources
PubMed1992

Factors related to the provision of hospital discounts for HMO inpatients.

Using 1986 AHA hospital survey data, we analyzed hospital-HMO contract provisions, hospital operating characteristics, and market conditions for a national sample of 801 hospitals with HMO contracts to determine the factors related to provision of a discount and the magnitude of the discount if present. Seventy-eight percent of the hospitals reported that at least one of their HMO contracts provided a discount for inpatient services. Risk-sharing provisions, the number of hospitals within a five-mile radius, the proportion of the population enrolled in HMOs, and the number of HMOs operating in the metropolitan statistical area (MSA) were directly related to provision of discounts. Public hospitals were less likely than other facilities to provide discounts. For the magnitude of the discounts, risk-sharing provisions and the number of hospitals within a five-mile radius were again related, as was the number of HMOs operating in the MSA--but this time the number-of-HMOs variable had an inverse relationship. The results suggest that increased HMO market activity does result in price competition for hospital services but that hospital discounting strategies are extremely complex and may not follow conventional market theories. Hospitals appear to be using contracts both to stabilize their relationships with HMOs and increase market share, and they are increasingly giving discounts to achieve those ends.

American Hospital Association↗
PubMed1991

Strategies employed by HMOs to achieve hospital discounts: a case study of seven HMOs.

This article is a summary of seven health maintenance organization (HMO) case studies focusing on strategies used to obtain favorable prices for inpatient hospital services. All of the HMOs stressed that the effort should be based on the local environment and should accommodate the special circumstances of organization of physicians' practices and hospitals, as well as the structure of the HMO and its strategic plan for growth.

Health Care Coalitions↗
PubMed1990

Health insurance coverage of Minnesota farm families.

This study of 1,482 farm families assesses the extent and cost of health insurance coverage among Minnesota farm families and finds that these families are buying less insurance coverage than urban families, while paying a higher proportion of their income for these premiums. More than three-fourths of the farm families surveyed buy their health insurance plan themselves and pay for it out of pocket. Their plans, on average, are slightly less expensive than employer-provided plans in urban areas, but they provide much less coverage and have more copayments and deductibles. Unlike their urban counterparts, who often choose health plans for convenience of location or freedom to choose physicians, farmers generally choose plans on the basis of costs and services provided. About 7 percent of farm families are without insurance, and many others are underinsured because they cannot afford to purchase an adequate plan.

Cost Control↗
PubMed1986

The impact of competitive health care systems on professional education.

The development of competitive markets for health services as a cost containment strategy and the attendant shift to the provision of services through large-scale organizations are having a profound effect on academic health sciences centers. At the University of Minnesota, where this transition is firmly in place, the teaching programs based at the University of Minnesota Hospital and Clinic are threatened as health maintenance organizations and similar provider systems restrict referrals to these institutions and limit lengths of stay. Moreover, large-scale provider organizations are becoming more influential in determining the content of the training programs. The University of Minnesota Health Sciences Center is attempting to improve its competitive position in health care delivery and reshape its teaching programs to reflect this new environment through strategic planning.

Academic Medical Centers↗
PubMed1984

Effects of contract management on hospital performance.

The performance of contract-managed (CM) hospitals is compared to that of a set of internally managed hospitals matched on a variety of hospital and market area characteristics. The performance of the study hospitals was similar to that of the matches in the years before the onset of contract management. Among 12 performance indicators, only occupancy rates differed significantly in the two samples in the years before contract management. Occupancy rates were lower on average in the hospitals which later became contract managed. During the 3 years following the onset of contract management, the CM hospitals showed no improvement in productive efficiency but did show changes in the way services were priced. The ratio of gross patient revenue to total expense increased significantly in the CM hospitals relative to their matches. This increase also appears to be associated with an increase in net profits in the CM hospitals relative to their matches.

Contract Services↗
PubMed1978

The formation and evaluation of a graduate program in health administration within a medical school.

Several aspects of the program in health administration that was established in 1968 by the faculty of the University of Colorado School of Medicine are described. Based on the premise that knowledge about the organization and the delivery of health services had not kept pace with the advances made in the scientific foundations of medicine, the program was designed to provide training in management, accounting, economics, medical care organization, quantitative methods, and in the other skills required for health administration. The results of a survey to identify the extent to which the program's graduates have fulfilled the original objectives are presented, including a description of the graduate's backgrounds and current job situations. The lessons learned from five year's experience teaching health administration within a medical school are also reviewed.

Colorado↗