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Payment contracts in a preventive health care system: A perspective from Operations Management

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  • Yaesoubi, Reza
  • Roberts, Stephen D.

Abstract

We consider a health care system consisting of two noncooperative parties: a health purchaser (payer) and a health provider, where the interaction between the two parties is governed by a payment contract. We determine the contracts that coordinate the health purchaser–health provider relationship; i.e. the contracts that maximize the population's welfare while allowing each entity to optimize its own objective function. We show that under certain conditions (1) when the number of customers for a preventive medical intervention is verifiable, there exists a gate-keeping contract and a set of concave piecewise linear contracts that coordinate the system, and (2) when the number of customers is not verifiable, there exists a contract of bounded linear form and a set of incentive-feasible concave piecewise linear contracts that coordinate the system.

Suggested Citation

  • Yaesoubi, Reza & Roberts, Stephen D., 2011. "Payment contracts in a preventive health care system: A perspective from Operations Management," Journal of Health Economics, Elsevier, vol. 30(6), pages 1188-1196.
    • Handle: RePEc:eee:jhecon:v:30:y:2011:i:6:p:1188-1196
    DOI: 10.1016/j.jhealeco.2011.08.009
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    References listed on IDEAS

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    1. Chalkley, Martin & Malcomson, James M., 1998. "Contracting for health services when patient demand does not reflect quality," Journal of Health Economics, Elsevier, vol. 17(1), pages 1-19, January.
    2. Boadway, Robin & Marchand, Maurice & Sato, Motohiro, 2004. "An optimal contract approach to hospital financing," Journal of Health Economics, Elsevier, vol. 23(1), pages 85-110, January.
    3. Reza Yaesoubi & Stephen Roberts, 2010. "A game-theoretic framework for estimating a health purchaser’s willingness-to-pay for health and for expansion," Health Care Management Science, Springer, vol. 13(4), pages 358-377, December.
    4. Jack, William, 2005. "Purchasing health care services from providers with unknown altruism," Journal of Health Economics, Elsevier, vol. 24(1), pages 73-93, January.
    5. Robert A. Shumsky & Edieal J. Pinker, 2003. "Gatekeepers and Referrals in Services," Management Science, INFORMS, vol. 49(7), pages 839-856, July.
    6. Prashant C. Fuloria & Stefanos A. Zenios, 2001. "Outcomes-Adjusted Reimbursement in a Health-Care Delivery System," Management Science, INFORMS, vol. 47(6), pages 735-751, June.
    7. Marinoso, Begona Garcia & Jelovac, Izabela, 2003. "GPs' payment contracts and their referral practice," Journal of Health Economics, Elsevier, vol. 22(4), pages 617-635, July.
    8. Barry Alan Pasternack, 1985. "Optimal Pricing and Return Policies for Perishable Commodities," Marketing Science, INFORMS, vol. 4(2), pages 166-176.
    9. Ma, Ching-to Albert, 1994. "Health Care Payment Systems: Cost and Quality Incentives," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 3(1), pages 93-112, Spring.
    10. Ma, Ching-to Albert & McGuire, Thomas G, 1997. "Optimal Health Insurance and Provider Payment," American Economic Review, American Economic Association, vol. 87(4), pages 685-704, September.
    11. Andrei Shleifer, 1985. "A Theory of Yardstick Competition," RAND Journal of Economics, The RAND Corporation, vol. 16(3), pages 319-327, Autumn.
    12. Z. Kevin Weng, 1995. "Channel Coordination and Quantity Discounts," Management Science, INFORMS, vol. 41(9), pages 1509-1522, September.
    13. Stephen E. Chick & Hamed Mamani & David Simchi-Levi, 2008. "Supply Chain Coordination and Influenza Vaccination," Operations Research, INFORMS, vol. 56(6), pages 1493-1506, December.
    14. Gérard P. Cachon & Martin A. Lariviere, 2005. "Supply Chain Coordination with Revenue-Sharing Contracts: Strengths and Limitations," Management Science, INFORMS, vol. 51(1), pages 30-44, January.
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    Cited by:

    1. Pengfei Guo & Christopher S. Tang & Yulan Wang & Ming Zhao, 2019. "The Impact of Reimbursement Policy on Social Welfare, Revisit Rate, and Waiting Time in a Public Healthcare System: Fee-for-Service Versus Bundled Payment," Service Science, INFORMS, vol. 21(1), pages 154-170, January.
    2. Elodie Adida & Hamed Mamani & Shima Nassiri, 2017. "Bundled Payment vs. Fee-for-Service: Impact of Payment Scheme on Performance," Management Science, INFORMS, vol. 63(5), pages 1606-1624, May.
    3. Reza Mahjoub & Fredrik Ødegaard & Gregory S. Zaric, 2018. "Evaluation of a pharmaceutical risk‐sharing agreement when patients are screened for the probability of success," Health Economics, John Wiley & Sons, Ltd., vol. 27(1), pages 15-25, January.

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