| Popis: |
State public employee health plans (PEHPs) are large employer-based health purchasers. Despite their size, little is known about the roles that PEHPs, as major purchasers, can or do play in the state health care environment. This dissertation explores two competing images of PEHPs to understand: 1) what accounts for different views on the roles that PEHP purchasers play within state health care systems, 2) how have different states leveraged the purchasing practices of PEHPs in an attempt to broadly influence aspects of state health care systems, and 3) what factors have characterized the experiences of these efforts. This dissertation finds that PEHPs represent potentially important actors in very large and sophisticated state health care systems. However, the purchasing power of PEHPs is not universal and immutable and is highly contingent on key political and market influences that may likewise drive PEHP policy variation across other states. It remains puzzling that policy scholars have largely ignored the roles that PEHPs, as major purchasers, can and do play in the state health care environment. Based on this initial study of PEHP policymaking in two states, however, much more research is needed to fully understand the factors driving PEHP policymaking and the roles that PEHPs play in state health care systems. |
