Journal ArticleDOI
Provider behavior under prospective reimbursement. Cost sharing and supply.
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TLDR
A mixed reimbursement system, in which hospital reimbursements are paid partly prospectively and partly cost-based, is shown to be superior to the other two reimbursement systems by improving the incentives for the efficient level of services, reducing incentives to unnecessarily admit or reclassify patients, and reducing risk to providers.About:
This article is published in Journal of Health Economics.The article was published on 1986-06-01. It has received 681 citations till now. The article focuses on the topics: Reimbursement & Cost sharing.read more
Citations
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The Economics of Health and Health Care
TL;DR: This book discusses the production, cost, and technology of health care, as well as the role of government intervention in health care markets and other topics.
Posted Content
Reimbursing Health Plans and Health Providers: Efficiency in Production versus Selection
TL;DR: In this article, the authors show that pure capitation payment leaves strong incentives for selection that are acted upon, and that the presence of contracting costs in a Rothschild-Stiglitz model means a limited pooling equilibrium can exist and that poor risks will not be at their preferred outcome.
Book ChapterDOI
The Anatomy of Health Insurance
TL;DR: The anatomy of health insurance can be found in this article, where the authors consider the optimal design of a health insurance policy that makes tradeoffs appropriately between risk sharing on the one hand and agency problems such as moral hazard and supplier-induced demand on the other.
Book ChapterDOI
Risk Adjustment in Competitive Health Plan Markets
TL;DR: A conceptual framework for thinking about risk adjustment is provided and several forms of risk sharing are discussed, which can be used as a tool for reducing selection in case of imperfect risk adjustment.
Journal ArticleDOI
Creaming, skimping and dumping: provider competition on the intensive and extensive margins.
TL;DR: The social optimum is compared to the private Cournot-Nash solution for three provider strategies: creaming--over-provision of services to low severity patients; skimping--under-propared services to high severity Patients; and dumping--the explicit avoidance of high severity patients.
References
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Journal ArticleDOI
Risk Sharing and Incentives in the Principal and Agent Relationship
TL;DR: In this article, the authors studied arrangements concerning the payment of a fee by a principal to his agent for such an arrangement, or fee schedule, to be Pareto optimal, it must implicitly serve to allocate the risk attaching to the outcome of the agent's activity in a satisfactory way and to create appropriate incentives for the agent in his activity.
Posted Content
Toward a theory of non-profit institutions: an economic model of a hospital
TL;DR: In this paper, a simple model of a hospital is developed, and its implications are considered, and an attempt is made to justify the realism of the model, although it cannot be entirely realistic.
Journal ArticleDOI
Medical insurance: A case study of the tradeoff between risk spreading and appropriate incentives☆
Book ChapterDOI
Supplier-Induced Demand: Some Empirical Evidence and Implications
TL;DR: The professional relationship arises from the significant information differential between physician and patient, and permits the physician to exert direct, non-price influence on the demand for his own services.
Journal ArticleDOI
A Controlled Trial of the Effect of a Prepaid Group Practice on Use of Services
TL;DR: The lower rate of use that the authors observed, along with comparable reductions found in non-controlled studies by others, suggests that the style of medicine at prepaid group practices is markedly less "hospital-intensive" and, consequently, less expensive.