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Provider-Based Managed Care Organisations and Products

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Healthcare Management

Part of the book series: Springer Texts in Business and Economics ((STBE))

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Abstract

Managed care allowed for the penetration of a variety of organisational forms instituted by providers of healthcare services. On the one hand, there are the traditional models such as Independent Practice Associations (IPAs) that defend the physicians’ interests as well as Preferred Provider Organisations (PPOs) that look after the interests of sales cooperatives. These exist beside other conventional network structures. In addition, two new organisational forms have developed. Accountable Care Organisations (ACOs) take charge of the healthcare provision for a specific population while Patient Centered Medical Homes (PCMHs) focus on care delivery on the General Practitioner’s level. This chapter will be dedicated to discussing this organisations and products.

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Notes

  1. 1.

    Shortell prefers this term in order to leave the term “integrated care system” open for organisational forms that are not yet on the market. These would also interact in direct cooperation with public social administrations for health management—Shortell et al. see its particular strength in this (Shortell et al. 1996, p. 8).

  2. 2.

    Thus Montefiore, one of the most significant healthcare systems in New York, invested $200 million in the establishment and expansion of IT over the last 10 years.

  3. 3.

    This premise, however, is not without critics, and there are sufficient examples that prove the opposite. Also refer to the chapter on gatekeeping.

  4. 4.

    Also this thesis, which is supported by Lega (2007), for example, is debated. Some supporters see specialist treatment as the more cost-effective variation since unnecessary misdiagnoses can be thus prevented.

  5. 5.

    The American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Physicians and the American Osteopathic Association.

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Authors and Affiliations

  1. Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover, Germany

    Volker Eric Amelung

  2. Institute of Health Sciences Research INAV GmbH, Berlin, Germany

    Volker Eric Amelung

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  1. Volker Eric Amelung
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Amelung, V.E. (2019). Provider-Based Managed Care Organisations and Products. In: Healthcare Management. Springer Texts in Business and Economics. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-59568-8_6

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  • DOI: https://doi.org/10.1007/978-3-662-59568-8_6

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