Trends in Managed Care Cost Containment: An Analysis of the Managed Care Backlash
研究了1998-2003年消费者对管理式医疗不满导致的反弹如何影响1998-2008年间短期非联邦医院的管理式医疗成本控制能力，发现HMO对住院成本的影响逆转，但对门诊成本仍有效。
Consumer dissatisfaction with the quality and limitations of managed health care led to rapid disenrollment from managed care plans and demands for regulation between 1998 and 2003. Managed care organizations, particularly health maintenance organizations (HMOs), now face quality and coverage mandates that restrict them from using their most aggressive strategies for managing costs. This paper examines the effect of this backlash on managed care's ability to contain costs among short-term, non-federal hospitals between 1998 and 2008. The results show that the impact of increased HMO penetration on inpatient costs reversed over the study period, but HMOs were still effective at containing outpatient costs. These findings have important policy implications for understanding the continuing role that HMOs should play in cost containment policy and for understanding how effective the latest wave of cost containment institutions may perform in heavily regulated markets.