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Selective contracting and channelling patients to preferred providers: A scoping review

Author

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  • Bes, Romy E.
  • Curfs, Emile C.
  • Groenewegen, Peter P.
  • de Jong, Judith D.

Abstract

Selective contracting by health insurers and channelling patients to contracted providers is crucial in a health care system based on managed competition, as this should lead to better value for money delivery of healthcare. However, an important consequence for enrolees is that health insurers interfere with their choice of care provider. This scoping review aims to find out what is known about selective contracting from the enrolee’s perspective. Is it being done and how do enrolees feel about the role of their health insurer in their care provider choice? A literature search was conducted, and, in addition, experts were consulted for extra information and documents. Results show that selective contracting and channelling are practised in several countries. This is mostly through negative financial incentives, which are also found to be the most effective strategy. However, enrolees are very negative about restrictions on provider choice introduced by their insurer. This results in enrolees feeling less satisfaction with, and trust in, care providers and health insurers. Choice is crucial in this respect since enrolees are more satisfied with their health plans and care providers when they have chosen them themselves. Future research should focus on the role of trust and how people weigh different attributes of health plans if selective contracting and channelling is to be implemented in a manner acceptable to enrolees.

Suggested Citation

  • Bes, Romy E. & Curfs, Emile C. & Groenewegen, Peter P. & de Jong, Judith D., 2017. "Selective contracting and channelling patients to preferred providers: A scoping review," Health Policy, Elsevier, vol. 121(5), pages 504-514.
    • Handle: RePEc:eee:hepoli:v:121:y:2017:i:5:p:504-514
    DOI: 10.1016/j.healthpol.2017.03.008
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    References listed on IDEAS

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    1. Boonen, Lieke H. H. M. & Schut, Frederik T., 2011. "Preferred providers and the credible commitment problem in health insurance: first experiences with the implementation of managed competition in the Dutch health care system," Health Economics, Policy and Law, Cambridge University Press, vol. 6(2), pages 219-235, April.
    2. Maarse, Hans & Jeurissen, Patrick & Ruwaard, Dirk, 2016. "Results of the market-oriented reform in the Netherlands: a review," Health Economics, Policy and Law, Cambridge University Press, vol. 11(2), pages 161-178, April.
    3. Thomson, Sarah & Busse, Reinhard & Crivelli, Luca & van de Ven, Wynand & Van de Voorde, Carine, 2013. "Statutory health insurance competition in Europe: A four-country comparison," Health Policy, Elsevier, vol. 109(3), pages 209-225.
    4. repec:mpr:mprres:3164 is not listed on IDEAS
    5. Marco Varkevisser & Stéphanie Geest, 2007. "Why do patients bypass the nearest hospital? An empirical analysis for orthopaedic care and neurosurgery in the Netherlands," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 8(3), pages 287-295, September.
    6. Lieke H. H. M. Boonen & Frederik T. Schut & Xander Koolman, 2008. "Consumer channeling by health insurers: natural experiments with preferred providers in the Dutch pharmacy market," Health Economics, John Wiley & Sons, Ltd., vol. 17(3), pages 299-316, March.
    7. Howard David H., 2008. "Hospital Quality and Selective Contracting: Evidence from Kidney Transplantation," Forum for Health Economics & Policy, De Gruyter, vol. 11(2), pages 1-24, March.
    8. Wu, Vivian Y., 2009. "Managed care's price bargaining with hospitals," Journal of Health Economics, Elsevier, vol. 28(2), pages 350-360, March.
    9. van de Ven, Wynand P.M.M. & Beck, Konstantin & Buchner, Florian & Schokkaert, Erik & Schut, F.T. (Erik) & Shmueli, Amir & Wasem, Juergen, 2013. "Preconditions for efficiency and affordability in competitive healthcare markets: Are they fulfilled in Belgium, Germany, Israel, the Netherlands and Switzerland?," Health Policy, Elsevier, vol. 109(3), pages 226-245.
    10. Duijmelinck, Daniëlle & van de Ven, Wynand, 2016. "What can Europe learn from the managed care backlash in the United States?," Health Policy, Elsevier, vol. 120(5), pages 509-518.
    11. Kelvin J. Lancaster, 1966. "A New Approach to Consumer Theory," Journal of Political Economy, University of Chicago Press, vol. 74, pages 132-132.
    12. Determann, Domino & Lambooij, Mattijs S. & de Bekker-Grob, Esther W. & Hayen, Arthur P. & Varkevisser, Marco & Schut, Frederik T. & Wit, G. Ardine de, 2016. "What health plans do people prefer? The trade-off between premium and provider choice," Social Science & Medicine, Elsevier, vol. 165(C), pages 10-18.
    13. Office of Health Economics, 2007. "The Economics of Health Care," For School 001490, Office of Health Economics.
    14. Alan T. Sorensen, 2003. "Insurer‐hospital bargaining: negotiated discounts in post‐deregulation connecticut," Journal of Industrial Economics, Wiley Blackwell, vol. 51(4), pages 469-490, December.
    15. Lieke Boonen & Frederik Schut & Bas Donkers & Xander Koolman, 2009. "Which preferred providers are really preferred? Effectiveness of insurers’ channeling incentives on pharmacy choice," International Journal of Health Economics and Management, Springer, vol. 9(4), pages 347-366, December.
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    2. Paul E. Orzechowski, 2018. "The Case for a Private Healthcare Insurance Monopoly," Applied Health Economics and Health Policy, Springer, vol. 16(4), pages 433-443, August.
    3. A Victoor & A E M Brabers & T E M van Esch & J D de Jong, 2019. "An assessment of the Dutch experience with health insurers acting as healthcare advisors," PLOS ONE, Public Library of Science, vol. 14(11), pages 1-13, November.
    4. Nicolet, Anna & Perraudin, Clémence & Krucien, Nicolas & Wagner, Joël & Peytremann-Bridevaux, Isabelle & Marti, Joachim, 2023. "Preferences of older adults for healthcare models designed to improve care coordination: Evidence from Western Switzerland," Health Policy, Elsevier, vol. 132(C).
    5. Groenewegen, Peter P. & Hansen, Johan & de Jong, Judith D., 2019. "Trust in times of health reform," Health Policy, Elsevier, vol. 123(3), pages 281-287.

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