Closed competitive bidding

This paper replaces the competitive bidding models of Friedman and Gates with a more general probabalistic bidding model which resolves the conflict between them. The validity of the model is demonstrated by simulation. Practical difficulties of using the probabalistic approach are discussed and several lines of future research suggested.     

A conversation on the future of health care

An extensive amount has been written, reported, and spoken on health care reform. It is a time of turmoil and uncertainty in the health care field. There is a great deal of talk at the federal level on reform, but efforts there seem to be at least temporarily stymied. Much is happening at the local and regional level, however, as the health care field itself wrestles with the changes that have already occurred and with the promise of changes that lie ahead. In the following conversation between two fictional physician executives, one with many years experience, the other his junior, some of the issues surrounding health care reform are discussed. Although the specific environment for the conversation is managed care, most physician executives will find themselves somewhere in the conversation. let's eavesdrop as they speak, in the late summer of 1994.     

Utilization management key to HMO success.

Utilization management has a long history in prepaid health programs, especially in capitated, prepaid risk programs that were the precursors of HMOs. Utilization management is commonly considered to be that set of systems and procedures used to ensure that a patient's medical needs are met at the least cost possible consistent with adequate quality. Examples of measures taken in managing utilization include avoiding unnecessary surgery, unnecessary hospitalization, excessive hospitalization, and unnecessary diagnostic and therapeutic measures, and encouraging use of less expensive means of care, such as home health care services. Also included, and of great importance, is obtaining those services at the least possible cost through favorable contracting for services.     

A positive experience with a consultant

Consulting services would not be the multimillion industry they are if the results were not of value to those using them. Obviously, consulting pays off in some large percentage of cases. But it does not happen automatically, and the consultant used is less important in the process than the advance work that is done by the client in establishing the conditions under which the consultation will take place. In the following example, preplanning led to a result that was immensely satisfying to all involved.     

Medicine, management, and me.

What is medical management? How do you learn about it? How do you get into it? Is there a future in it? Is medical management for you? Can you do it? What will it mean to your original plans for your life in medicine? Is it worth the sacrifice? Get comfortable. I have a story to tell you. It may help if you hear about medical management from a medical director who has preceded you. I doubt I can answer all your questions. I can, however, tell you about one physician's visions, expectations, decisions, experiences, and rewards from what can be loosely called "medical management." If you find something of help in your decision making in this account, my telling it is worthwhile.     

The Outward Projection of Italian Firms: Facts and Figures on Foreign Affiliates

In the last two decades or so, globalisation has prompted a great deal of attention in the study of the international organisation of production, with in-depth industry studies on its welfare effects, both for firms and for workers. Outcomes did not prove a unique direction of effects, although the heterogeneous firms?? approach emphasised the intra-industry reallocation through intra-sectoral international competition. Thus, differences in the inner structure of companies filled the gap on the micro-level analysis that featured the study of international trade for several decades, although there is still the need to understand the effects of internationalisation on local systems of production and link such results to the consolidated meso-level of analysis of trade flows. Thanks to the microdata provided by the Italian Statistical Office (ISTAT), we are able to access information on the presence of Italian firms abroad, distinguished by geographical area of origin, destination and industry and check for their influence on affiliates?? structure and performance through appropriate indicators.