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Healthcare payor management practices are associated with health system performance and population health

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  • Dorgan, Stephen J.
  • Powell-Jackson, Timothy
  • Briggs, Andrew

Abstract

Good management practice has long been seen as critical to improving the performance, quality, and efficiency of healthcare systems. Better hospital management practice has been shown to correlate with improved clinical quality and performance. However, the association between the management practices of healthcare payors, the performance of the healthcare systems they oversee, and the health of their managed populations, has not been explored quantitatively. We collected data for all 152 healthcare payors and 53 million residents in England to explore the relationships between payor management practices and the performance of the healthcare system each payor managed. First, we found that better healthcare payor management practices are associated with improved health system performance in the domains of quality and value for money, and with improvements in the overall health and well-being of the managed population. Second, we found better payor management practice is associated with improvements in specific outcome metrics related to healthcare system effectiveness, safety, and value for money. Finally, we found no association between payor management practices and metrics for patient experience and access. These findings provide the first known quantitative evidence of a link between healthcare payor management practice and health system performance. They may also help both governments and payors themselves understand what healthcare system performance improvements might be possible from improving the management practices of healthcare payors.

Suggested Citation

  • Dorgan, Stephen J. & Powell-Jackson, Timothy & Briggs, Andrew, 2025. "Healthcare payor management practices are associated with health system performance and population health," Social Science & Medicine, Elsevier, vol. 368(C).
  • Handle: RePEc:eee:socmed:v:368:y:2025:i:c:s0277953625001091
    DOI: 10.1016/j.socscimed.2025.117780
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    1. Yoav Benjamini & Abba M. Krieger & Daniel Yekutieli, 2006. "Adaptive linear step-up procedures that control the false discovery rate," Biometrika, Biometrika Trust, vol. 93(3), pages 491-507, September.
    2. repec:cdl:agrebk:qt15n8j26f is not listed on IDEAS
    3. Nicholas Bloom & John Van Reenen, 2007. "Measuring and Explaining Management Practices Across Firms and Countries," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 122(4), pages 1351-1408.
    4. Daniela Scur & Raffaella Sadun & John Van Reenen & Renata Lemos & Nicholas Bloom, 2021. "The World Management Survey at 18: lessons and the way forward," Oxford Review of Economic Policy, Oxford University Press and Oxford Review of Economic Policy Limited, vol. 37(2), pages 231-258.
    5. K. John McConnell & Richard C. Lindrooth & Douglas R. Wholey & Thomas M. Maddox & Nick Bloom, 2016. "Modern Management Practices and Hospital Admissions," Health Economics, John Wiley & Sons, Ltd., vol. 25(4), pages 470-485, April.
    6. Nicholas Bloom & Renata Lemos & Raffaella Sadun & John Van Reenen, 2020. "Healthy Business? Managerial Education and Management in Health Care," The Review of Economics and Statistics, MIT Press, vol. 102(3), pages 506-517, July.
    7. Anderson, Michael L., 2008. "Multiple Inference and Gender Differences in the Effects of Early Intervention: A Reevaluation of the Abecedarian, Perry Preschool, and Early Training Projects," Journal of the American Statistical Association, American Statistical Association, vol. 103(484), pages 1481-1495.
    8. De Regge, Melissa & Eeckloo, Kristof, 2020. "Balancing hospital governance: A systematic review of 15 years of empirical research," Social Science & Medicine, Elsevier, vol. 262(C).
    9. Smith, Peter C. & Stepan, Adolf & Valdmanis, Vivian & Verheyen, Piet, 1997. "Principal-agent problems in health care systems: an international perspective," Health Policy, Elsevier, vol. 41(1), pages 37-60, July.
    10. repec:plo:pone00:0210624 is not listed on IDEAS
    11. McConnell, K. John & Lindrooth, Richard C. & Wholey, Douglas R. & Maddox, Thomas M. & Bloom, Nicholas, 2013. "Management practices and the quality of care in cardiac units," LSE Research Online Documents on Economics 59336, London School of Economics and Political Science, LSE Library.
    12. Dorgan, Stephen J. & Powell-Jackson, Timothy & Briggs, Andrew, 2024. "Measuring healthcare payor management practices in England," Social Science & Medicine, Elsevier, vol. 340(C).
    13. Sandra G. Sosa-Rubí & Sergio Bautista-Arredondo & Carlos Chivardi-Moreno & David Contreras-Loya & Gina Hera-Fuentes & Marjorie Opuni, 2021. "Efficiency, quality, and management practices in health facilities providing outpatient HIV services in Kenya, Nigeria, Rwanda, South Africa and Zambia," Health Care Management Science, Springer, vol. 24(1), pages 41-54, March.
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