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Full-Text Articles in Law
The New Economic Credentialing: Protecting Hospitals From Competition By Medical Staff Members, Elizabeth Weeks
The New Economic Credentialing: Protecting Hospitals From Competition By Medical Staff Members, Elizabeth Weeks
Scholarly Works
This Article addresses hospitals' use of economic criteria to determine a physician's qualifications for staff privileges. Hospitals are resorting to economic conflict-of-interest credentialing policies in an attempt to ensure physicians' loyalty and mantain their own economic viability. Physicians, however, argue that entrepenurial activities are necessary for them to meet the economic challenges posed by declining reimbursement and rising insurance costs. This Article surveys the numerous legal theories that litigants and enforcement authorities could employ in attacking these new types of credentialing policies. The Article concludes that, in most jurisdictions, hospitals should be able to implement their policies in ways that …
Putting Health Care Providers At A Loss And Consumers At Risk: Why Hmos Should Be Held Accountable For The Financial Instability Of Their Delegated Networks., Anish P. Michael
Putting Health Care Providers At A Loss And Consumers At Risk: Why Hmos Should Be Held Accountable For The Financial Instability Of Their Delegated Networks., Anish P. Michael
St. Mary's Law Journal
This Comment explores why health maintenance organizations (HMOs) such as PacifiCare should be held accountable for the financial instabilities of their delegated networks. Part II discusses the organization of the managed care system and the assessment of Texas laws currently enforcing managed care in the state. Incorporated in this discussion is a look at the risks delegated networks bear when contracting with HMOs to provide payment for individualized care. Part III analyzes the increasing trend of financial instability by presenting the views of the HMOs, the delegated networks, the health care providers, and the consumers enrolled in the health plan. …
Why We Need The Independent Sector: The Behavior, Law, And Ethics Of Not-For-Profit Hospitals, Jill R. Horwitz
Why We Need The Independent Sector: The Behavior, Law, And Ethics Of Not-For-Profit Hospitals, Jill R. Horwitz
Articles
Among the major forms of corporate ownership, the not-for-profit ownership form is distinct in its behavior, legal constraints, and moral obligations. A new empirical analysis of the American hospital industry, using eleven years of data for all urban general hospitals in the country, shows that corporate form accounts for large differences in the provision of specific medical services. Not-for-profit hospitals systematically provide both private and public goods that are in the public interest, and that other forms fail to provide. Two hypotheses are proposed to account for the findings, one legal and one moral. While no causal claims are made, …