2007 年 2007 巻 22 号 p. 113-121,162
This paper analyzes the relationship between organizational form and its healthcare insurance plan which is sold in managed care market in USA. In managed care plan, there are PPO (Prepaid Provider Organization) which adopts FFS (Fee-for-Service) and HMO (Health Maintenance Organization) and POS (Point of Service) which adopts capitation payment, and these plans become the major healthcare insurance in USA today.
As results of using multinominal logit model, it is found the followings. First, profitoriented organizations tend to sell PPO which is easier to earn the profit than HMO. Second, Insurance Companies of Blue Cross/Sheild series tend to sell HMO which do not charge out-of-pocket per services. Third, HMO and POS which is required strict management of quality of services tend to be accredited by evaluation organizations.