Throughout the 1990's, the US healthcare system has increasingly become investor owned. Increasing numbers of hospitals, HMOs, nursing homes, home care services, and hospices became for-profit companes, publicly traded on the stock exchange. However, all segments of the health care industry have been affected, even the non-profit companies because in order to remain competitive, the non-profits have had to utilize the same cost-cutting practices as the for-profits.
The intensified competition among health care companies and investors' pressure for returns have led to cost-containment practices and monitoring of health care professionals by non-physicians. Ironically, the competition, once touted as the source of efficiency and cost-containments, has now intensified to the point where profit margins are seriously narrowed. This has great implications for the influence of Wall Street. Since 1997, HMOs as a whole have posted great losses and show no signs of abating. As the managed care companies have felt the financial squeeze, they have implemented more cost-cutting practices which in turn have led to consumer backlash and regulatory backlash (the competition vs. regulation balance we talked about in class). Furthermore, Wall Street's influence has resulted in many mergers, consolidations and acquisitions as managed care companies try to remain competitive by gaining more of the market share.
WEBSITES
1. Federal Trade Commission Home Page
This web site is the home page of the Federal Trade Commission which works for consumer protection and a competitive marketplace. The site provides current news releases regarding consumer protection, business guidance, formal actions, opinions & activities, antitrust/competition, economic issues and new releases, publications & speeches. Its relevance to wall street and managed care is acute in the area of antitrust and competition. The site is useful to finding current news -- use the keyword "managed care" and numerous articles appear with rankings according to its relevance. The site is user-friendly. Rating: *** 3 stars
2. National Center for Policy Analysis, Idea House
The NCPA is a nonprofit public policy research institute and their website offers a wealth of analysis, debate, and in-depth research from around the world. The usefulness of this site in learning about wall street and managed care is limited by the breadth of topics. However, it does breakdown issues into topics including health care which narrows the scope but overall, the site is not very helpful. The most useful aspect of this site is that it has one of the most extensive research links I have encountered but unfortunately, it is not organized very well, if at all. The site itself is user-friendly but the research links, again, should be organized to help the user. Rating: ** 2 stars
The purpose of this site is to keep the user up-to-date about wall street and the market in general. While this site is not specific for managed care nor health care, it does breakdown topics in various ways, including by industry. However, the usefulness of this site is in its great search engine. Search under keywords "managed care and wall street" and a plethora of articles appear, including those about wall street and specific managed care companies. Furthermore, the search results can be sorted by relevance or by date of articles. The site is very user-friendly. Rating: *** 3 stars
4. Health Care Business News - Monday Morning
This site provides weekly updates about health care business news including managed care and the wall street market. It also has a link to its archive and related links to other publications, news sources and associations which add to the utility of this site. Very user-friendly. Rating: **** 4 stars
This site includes daily briefings of managed care news from around the web, special focus areas, and a search engine for its archives. The briefings are concise and link the user to the specific sites for the full articles, a function which is very, very useful. However, the briefings themselves are not limited to wall street but may be narrowed down by using the search engine. Very user-friendly. Rating: **** 4 stars
DOCUMENTS
This document is written by Clive Riddle, President of Managed Care On-Line, a health care information technology company that specializes in delivering managed care information via the internet. This document gives a very good, albeit quick-and-dirty, look at managed care: the players, quick history, the business of health care and wall street, the current headlines and managed care backlash, and the future. It gives a good summary of the premium pricing cycle -- the business side -- in a very understandable manner to the lay reader. User-friendly. Rating: **** 4 stars
This document reports on the results of a survey that predicts by the year 2000, there will be few completely independent, freestanding hospitals (only 12%) due to market competition and pressure imposed by wall street and managed care. It gives reasons for the trend toward collaboration, mergers and acquisitions and suggests criteria for hospitals choosing a collaborative partner. A helpful and user-friendly site. Rating: **** 4 stars
3. Bayerquality Top Ten Healthcare Trends for 1997
This document is written by Russ Coile, a consultant in the healthcare industry who provides forecasts and strategic advice. His past predictions boast accuracy rates in the 90+ percentages. While his top ten healthcare trends seem right on, only a couple of them deal with the topic of managed care and wall street, specifically, the continuation of mergers and acquisitions, and HMO growth and price increases. Limited utility but user-friendly. Rating: ** 2 stars
4. Markets and Plan Performance: Case Studies of IPA and Network HMOs
This 1996 document discusses the trend of increasing HMO enrollment, mergers, acquisitions, and conversion to for-profit status as plans seek access to capital for growth. Case studies of independent practice associations (IPAs) and network model HMO’s concluded that size and growth may be more important for plan survival than the quality of patient care and services. The study also cited the characteristics of the most and least financially successful plans. The latter I found to be the most interesting and helpful. User-friendly. Rating: *** 3 stars
5. Columbia/HCA chief finds opportunity in chaotic environment
This document is an article discussing Columbia/HCA’s domination in
Ohio as it bought up hospitals in Ohio in 1995. It quotes the president
and CEO of Columbia/HCA Healthcare Corp, Richard L. Scott, on his opinions
of hospital merger and acquisition trends and the then proposed $270 billion
cut in Medicare and Medicaid benefits being debated in Congress at the
time. Limited utility -- more general reporting of events rather than insightful
discussion of trends and principles. User-friendly. Rating: * 1 star
| Note: The information below may contain additional relevant materials and documents. Some of the information may be duplicate. The evaluations depend on both the student doing the review and the information contained at the time of the review. Sites are subject to change! |