Using Subjective Risk Adjusting to Prevent Patient Dumping in the Health Care Industry
AbstractWe examine how to procure health care services at minimum cost while preventing suppliers from refusing to care for high-cost patients. A single risk-adjusted prospective payment is optimal only when it is particularly costly for the supplier to discover likely treatment costs. Cost sharing is optimal when these screening costs are somewhat smaller. When screening costs are sufficiently small, screening is optimally accommodated and subjective risk adjusting is implemented. Under subjective risk adjusting, the supplier classifies patients according to his personal assessment of likely treatment costs, and payments are structured accordingly. Optimal procurement policies are contrasted with prevailing industry policies. Copyright (c) 1999 Massachusetts Institute of Technology.
Download InfoIf you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.
Bibliographic InfoArticle provided by Wiley Blackwell in its journal Journal of Economics & Management Strategy.
Volume (Year): 8 (1999)
Issue (Month): 3 (09)
Contact details of provider:
Web page: http://www.kellogg.northwestern.edu/research/journals/JEMS/
You can help add them by filling out this form.
CitEc Project, subscribe to its RSS feed for this item.
- Erik SCHOKKAERT & Carine VAN DE VOORDE, 2000.
"Risk Selection and the Specification of the Conventional Risk Adjustment Formula,"
Center for Economic Studies - Discussion papers
ces0011, Katholieke Universiteit Leuven, Centrum voor Economische Studiën.
- Schokkaert, Erik & Van de Voorde, Carine, 2004. "Risk selection and the specification of the conventional risk adjustment formula," Journal of Health Economics, Elsevier, vol. 23(6), pages 1237-1259, November.
- Makoto Kakinaka & Ryuta Ray Kato, 2011.
"Regulated Medical Fee Schedule of the Japanese Health Care System,"
EMS_2011_13, Research Institute, International University of Japan.
- Makoto Kakinaka & Ryuta Kato, 2013. "Regulated medical fee schedule of the Japanese health care system," International Journal of Health Care Finance and Economics, Springer, vol. 13(3), pages 301-317, December.
- Chalkley, Martin & Khalil, Fahad, 2005.
"Third party purchasing of health services: Patient choice and agency,"
Journal of Health Economics,
Elsevier, vol. 24(6), pages 1132-1153, November.
- Fahad Khalil & Martin Chalkley, 2005. "Third Party Purchasing of Health Services: Patient Choice and Agency," Working Papers UWEC-2003-35-P, University of Washington, Department of Economics.
- Martin Chalkley & Fahad Khalil, 2001. "Third Party Purchasing and Incentives: The "Outcome Movement" and Contracts for Health Services," Dundee Discussion Papers in Economics 125, Economic Studies, University of Dundee.
- Karen Eggleston, 2001. "Multitasking, Competition and Provider Payment," Discussion Papers Series, Department of Economics, Tufts University 0101, Department of Economics, Tufts University.
- Yujing Shen & Randall P. Ellis, 1999.
"Cost-Minimizing Risk Adjustment,"
0097, Boston University - Industry Studies Programme.
- Barros, Pedro Pita, 2003. "Cream-skimming, incentives for efficiency and payment system," Journal of Health Economics, Elsevier, vol. 22(3), pages 419-443, May.
- Mougeot, Michel & Naegelen, Florence, 2008. "Supply-side risk adjustment and outlier payment policy," Journal of Health Economics, Elsevier, vol. 27(5), pages 1196-1200, September.
- Dalen, Dag Morten & Moen, Espen R & Riis, Christian, 2009. "Designing Competition in Health Care Markets," HERO On line Working Paper Series 2001:3, Oslo University, Health Economics Research Programme.
- Siciliani, Luigi, 2006. "Selection of treatment under prospective payment systems in the hospital sector," Journal of Health Economics, Elsevier, vol. 25(3), pages 479-499, May.
- Stam, Pieter J.A. & van Vliet, René C.J.A. & van de Ven, Wynand P.M.M., 2010. "A limited-sample benchmark approach to assess and improve the performance of risk equalization models," Journal of Health Economics, Elsevier, vol. 29(3), pages 426-437, May.
- Pablo Picasso, 2000. "Capitation," Macroeconomics 0004064, EconWPA, revised 23 Aug 2001.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Wiley-Blackwell Digital Licensing) or (Christopher F. Baum).
If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.
If references are entirely missing, you can add them using this form.
If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.
If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.
Please note that corrections may take a couple of weeks to filter through the various RePEc services.