Managing Costs, Managing Benefits: Employer Decisions in Local Health Care Markets

Feb. 21, 2003
Health Services Research, 38:1, Part II (February 2003), pp. 357-373
Jon B. Christianson, Sally Trude

The tight labor market during the study period was the dominant consideration in employer decision making regarding health benefits. Employers, in managing employee compensation, made independent decisions in pursuit of individual goals, but these decisions were shaped by similar labor market conditions. As a result, within and across our study sites, employer decisions in aggregate had an important impact on local health care systems, although employers' more highly visible public efforts to bring about health system change often met with disappointing results.

General economic conditions in the 1990s had an important impact on the configuration of local health systems through their effect on employer decision making regarding health benefits offered to employees, and the responses of health plans and providers to those decisions.

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