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Biomedical subjects

W Greenberg

Publications and source records attributed to W Greenberg.

7 recordsLinked to original sources

The competitive response of Blue Cross and Blue Shield to the health maintenance organization in Northern California and Hawaii.

The health maintenance organization (HMO) can provide an alternative to the predominant form of health care delivery in the United States, fee-for-service. Although market penetration of the HMO is relatively low in most parts of the country, the HMO has achieved a significant market share in a number of states. This paper examines the competitive response of Blue Cross and Blue Shield to the introduction of the HMO in two geographic regions with significant HMO activity, northern California and Hawaii. The evidence obtained from extensive interviews indicates that Blue Cross and Blue Shield plans have responded to HMO competitive pressure by establishing their own HMOs and by altering traditional procedures. HMO competition has stimulated Blue Cross and Blue Shield to make greater cost control efforts and to offer larger benefit packages. These results can have important policy implications for the role that HMOs are to play in cost containment.

Blue Cross Blue Shield Insurance Plans

Influence of population on the classification of ECG-VCG's using linear regression techniques.

This paper describes the influence of different populations on statistical multivariate classification rules and classification results where the word "population" refers only to the frequency of diagnoses to be expected, the so-called prior probabilities. Using linear regression as a multivariate classification technique and six groups consisting of five pathological conditions and normals as test data, it has been shown: (a) That the population influences to a great extent the selection of the best ECG-VCG measurements for the classification rule. (b) That a mismatch of the populations in the learning and test sets can considerably decrease the number of correct classifications. (c) That a certain correction of the mismatch can be achieved when the prior probabilities in the learning and test sets are known, Further, the paper discusses the change of prior probabilities over the years at the Variety Club Heart Hospital in the University of Minnesota and its effect on the performance of the classification algorithm which has been used.

Electrocardiography

The effect of physician-controlled health insurance. U.S. v. Oregon State Medical Society.

The trial record in an antitrust case against the Oregon State Medical Society, finally decided in 1952, was examined to reconstruct the behavior of a competitive market for health insurance coverage. Health insurers, called "hospital associations," were found to have engaged individually in cost-control efforts similar to, but possibly more aggressive than, today's utilization review under professional sponsorship. The subsequent disappearance of these insurer-initiated cost controls in Oregon is traced to the medical society's organization of a competing Blue Shield plan as a model of insurer conduct and to a simultaneous boycott by physicians of the hospital associations as long as they persisted in questioning doctors' practices. Some modern parallels are noted, and the advantages of fostering privately sponsored cost-control efforts are suggested.

Hospitals