Conflict, Conclusion

Question 1

for major actors of health care

Answer 1

purchaers
insurers
providers
suppliers

Question 2

purchasers

Answer 2

supply funds

individuals

Question 3

insurers

Answer 3

receive money from purchasers and reimburse providers

some insurers are the same as purhcasers

Question 4

providers

Answer 4

individuals that provide health care (can also be insurers(HMO)

Question 5

suppliers

Answer 5

produce supplies, equipment, etc.

Question 6

mean US inflation

Answer 6

2-2.5% inflation

Question 7

historical relationships 90’s

Answer 7

provider insurer relationship becomes more antagonistic

Question 8

historical relationships 200’s

Answer 8

provider power reemerges
HMO’s fade / evolve
physicians form multiple specialty groups
pharma challenged
providers consolidate, limit competition, improve contract negotiating power

Question 9

major trends today

Answer 9

“provider counter revolution- hospitals and clinicians push backk against aggressive decreased in reimbursements by MCOs and other insurers

consolidation: payers consolidate

growth of specialist/specialty services

Question 10

the 2010’s

Answer 10

less uninsurace, more underinsurance

increased coverage, focus on value vs volume

Question 11

what was the major theme of the post war era (1945-1970)

Answer 11

providers had more power than payers

Question 12

what was the theme os the 1970/s

Answer 12

insurers push/ drive reimbursement