Physician Incentive Programs: Is it Possible to Develop Incentive Programs that Provide Financial Incentives for Primary Care Physicians while Balancing Quailty Medicine and Utilization Controls?

Managed care organizations have focused on utilization controls through the use of managed care techniques as a manner of containing costs. Managed care techniques such as selective contracting, risk sharing and risk adjustment, gatekeepers, medical management and utilization review have presented a more measurable means o f financially incentivizing the primary care physician. However, has the focus on utilization controls been at the expense of practicing quality care medicine? Compensation that rewards physicians for withholding care can interfere with physicians’ loyalty to patients and ultimately their candor and trust. Structural incentives to reduce cost can be effective if they are not so direct and substantial to influen ce medical decisions. Thoughtful incentive structures can use measures o f quality and patient satisfaction instead o f rewarding less costly treatment decisions. How do we develop and balance these incentive structures and what other issues need to be taken into consideration? Thus, in order to find a solution for such a complex issue, the complexity needs to be analyzed and defined. My research will utilize information already available on utilization controls and quality incentives to help better understand the existing relationships and structure. Additionally, my research will include gathering and analyzing data on two existing quality incentive programs to determine the effectiveness o f using financial incentives for practicing quality medicine. The findings o f this research will provide health care administrators with a cost / benefit analysis of the development of similar and more extensive models.Master'sCollege of Arts and Sciences: Public AdministrationUniversity of Michiganhttp://deepblue.lib.umich.edu/bitstream/2027.42/117813/1/JonesC.pd

White flight? : George Pepperdine College\u27s move to Malibu, 1965-1972

George Pepperdine College, a Church of Christ affiliated institution of higher education in Los Angeles, California, had its foundation rocked in the 1960s by two events: The Watts Riots of 1965 and the 1969 shooting of Los Angeles youth, Larry Donnell Kimmons. These events challenged the original commitment that founder George Pepperdine had for the Los Angeles area and forever changed the future direction of George Pepperdine College (GPC). The Watts Riots served as the catalyst, generating a desire by the executive administrators of GPC to leave the perceived chaotic and unpredictable urban setting. The second event, the tragic shooting of Larry Kimmons on the college campus by a campus security guard, ignited Black Nationalist sentiment within the GPC student population and local Los Angeles community. This fervor, which manifested itself in student protests and vandalism, scared GPC administrators and justified their decision to move the institution from the founding location. This thesis will examine the early history of GPC in Los Angeles, the Churches of Christ attitude on Race Relations in American and the Social Gospel, the events surrounding the Kimmons murder and subsequent student reaction, and the actual move to Malibu which in university published material is referred to as the Miracle in Malibu. Ultimately, this work will demonstrate that the direct and indirect consequences of the Watts Riots and the 1969 shooting of Larry Kimmons brought about the college\u27s move to Malibu

Qualitatively capturing institutional logics

There is an ever-increasing volume of studies investigating institutional logics, and yet qualitative methods for studying this phenomenon are not clear. In this essay, we examine how qualitative scholars convince their readers that they are actually studying institutional logics. We identify three different, but non-exclusive techniques that have been employed: pattern deducing, pattern matching, and pattern inducing. For each of these approaches, we explain the ontological assumptions, methodological techniques, challenges, and benefits. In addition, we provide examples of how specific studies have analyzed and presented qualitative data to improve theory about institutional logics.</jats:p