TY - JOUR
T1 - Market and plan characteristics related to HMO quality and improvement
AU - Scanlon, Dennis P.
AU - Swaminathan, Shailender
AU - Chernew, Michael
AU - Lee, Woolton
PY - 2006/12/1
Y1 - 2006/12/1
N2 - Existing research on health plan performance examines whether variation in plans' scores is related to enrollee and health plan traits, primarily using cross-sectional research designs. This study extends that literature by incorporating data on market characteristics using a longitudinal framework. We estimate multivariate growth models that relate plan performance on standard measures to market and HMO characteristics using an unbalanced panel of data for 1998 to 2002. We find that HMO competition is not associated with better performance or greater rates of improvement in performance on the HEDIS chronic care measures. HMO penetration, on the other hand, is positively associated with HEDIS performance in several of the chronic care process-and-outcomes measures but not with a greater rate of improvement through time. Our analysis indicates that a significant percentage of the unexplained variation in quality improvement is because of permanent, unobserved plan-level characteristics that future research should strive to identify.
AB - Existing research on health plan performance examines whether variation in plans' scores is related to enrollee and health plan traits, primarily using cross-sectional research designs. This study extends that literature by incorporating data on market characteristics using a longitudinal framework. We estimate multivariate growth models that relate plan performance on standard measures to market and HMO characteristics using an unbalanced panel of data for 1998 to 2002. We find that HMO competition is not associated with better performance or greater rates of improvement in performance on the HEDIS chronic care measures. HMO penetration, on the other hand, is positively associated with HEDIS performance in several of the chronic care process-and-outcomes measures but not with a greater rate of improvement through time. Our analysis indicates that a significant percentage of the unexplained variation in quality improvement is because of permanent, unobserved plan-level characteristics that future research should strive to identify.
UR - http://www.scopus.com/inward/record.url?scp=33750534993&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33750534993&partnerID=8YFLogxK
U2 - 10.1177/1077558706293835
DO - 10.1177/1077558706293835
M3 - Article
C2 - 17099130
AN - SCOPUS:33750534993
SN - 1077-5587
VL - 63
SP - 56S-89S
JO - Medical Care Research and Review
JF - Medical Care Research and Review
IS - 6
ER -