Like all other States, the State of North Dakota health care delivery system is concerned about cost, accessibility and quality of health care services at a reasonable cost. North Dakota has a population of approximately 672 591 people, with most of the population is white (92%), with a small minority of Native Americans (5%) representing four tribal nations. In addition, North Dakota ranks in the top quartile of states on The Commonwealth Fund’s State Scorecard on Health System Performance, which ranks states according to their performance across 32 key indicators of access, quality, utilization, equity, …show more content…
Blue Cross Blue Shield of North Dakota (BCBS-ND) is the dominant health insurer in the state, holding 80 percent of the market with 275,000 insured members in North Dakota. (Retrieved from,http://www.commonwealthfund.org/usr_doc/1130_McCarthy_North_Dakota_experience.pdf?section=4039).
The main competitive forces in the healthcare delivery system
The main competitive forces in the state of North Dakota. The main competitive force is expanding access to healthcare to rural areas while maintaining cost and quality of the health delivery services provided. Competition in health care involves prices, supply and demand, quality of care, convenience, and products or services. Porter and Teisberg have noted that:
In a normal market, competition drives relent- less improvement in quality and cost. Rapid innovation leads to rapid diffusion of new technologies and better ways of doing things. Excellent competitors prosper and grow, while weaker rivals are restructured or go out of business. Quality-adjusted prices fall, value improves, and the market expands to meet the needs of more …show more content…
The HMO sells the health insurance coverage to customers on a per capita basis. The HMO assumes all responsibilities including financial risk for providing the care. The HMO is reliant on the providers to assess the HMO member’s condition and to provide appropriate levels of care. From the health care facility perspective, Health Maintenance Organization (HMOs) objective is to maximize profit, in efforts to increase and improve the quality of care to its members while the physician objective is to maximize net income. Healthcare providers will be forced to become more pre-conscious and cost-effective if HMOs gain market shares. HMOs reduce costs through fixed budget financing, reduced inpatient utilization by keeping customers out of hospitals, and using fewer resources once a customer is admitted. If HMOs control significant amounts of patient volume, the competitive impact will concentrate on health care system costs. As a result of low health care system costs, customers are likely to enjoy low services charges and become more satisfied, which is also an advantage to the employer and the insurer. A disadvantage to the Health Maintenance Organization is that members are restricted to only HMO physicians and the insurer must obtain a referral from their primary physician before seeing a specialist (Reddick, 2007). The biggest advantage of an HMO for the