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Budgetbereinigung zwischen Kollektiv- und Selektivvertrag: oekonomische Aspekte aus wettbewerblicher Sicht

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Author Info

  • Juergen Zerth

    ()
    (Universitaet Bayreuth)

  • Stefanie Daum

    ()
    (Universitaet Erlangen-Nuernberg)

Abstract

The extraction of a selective contract from a collectively financed fund needs an appropriate method of adjustment. This is necessary as long as the fund guarantees basic benefits, irrespective of the contractual form of service provision. In this context externalities arise which may not be internalized by the partner of a selective contract.We look at externalities in the context of a collectively financed fund where insurers and health care providers can contract forms of managed care that need an adjustment scheme.We show that in a first-best static world, unique reimbursement schemes between collective and selective contracts are appropriate. From a dynamic perspective problems of externalities between collective and selective contracts increase due to the requirement of an enduring commitment scheme between the health care providers and the cost-payers. But some simple form of cost-sharing ideas in which the patient is also involved can help to achieve a pareto-optimal equilibrium. This commitment strategy will be easier to organise if the selective contract is connected with a process innovation. Altogether, the dynamic commitment strategymay only work if health care providers as well as cost-payers compete actively.

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Bibliographic Info

Article provided by Justus-Liebig University Giessen, Department of Statistics and Economics in its journal Journal of Economics and Statistics.

Volume (Year): 232 (2012)
Issue (Month): 4 (July)
Pages: 460-481

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Handle: RePEc:jns:jbstat:v:232:y:2012:i:4:p:460-481

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Related research

Keywords: Selective contracting; externality; competition in health care markets;

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References

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  1. Thomas G. McGuire & Jacob Glazer, 2000. "Optimal Risk Adjustment in Markets with Adverse Selection: An Application to Managed Care," American Economic Review, American Economic Association, vol. 90(4), pages 1055-1071, September.
  2. Martin Gaynor & William B. Vogt, 1999. "Antitrust and Competition in Health Care Markets," NBER Working Papers 7112, National Bureau of Economic Research, Inc.
  3. Lynk, William J., 1995. "The creation of economic efficiencies in hospital mergers," Journal of Health Economics, Elsevier, vol. 14(5), pages 507-530, December.
  4. Gérard Pouvourville, 2006. "Risk-sharing agreements for innovative drugs," The European Journal of Health Economics, Springer, vol. 7(3), pages 155-157, September.
  5. H. Brown & José Pagán, 2006. "Managed care and the scale efficiency of US hospitals," International Journal of Health Care Finance and Economics, Springer, vol. 6(4), pages 278-289, December.
  6. Axel Boersch-Supan, 2007. "Vertragswettbewerb im Gesundheitswesen," Journal of Economics and Statistics (Jahrbuecher fuer Nationaloekonomie und Statistik), Justus-Liebig University Giessen, Department of Statistics and Economics, vol. 227(5+6), pages 451-465, December.
  7. Herndon, Jill Boylston, 2002. "Health insurer monopsony power: the all-or-none model," Journal of Health Economics, Elsevier, vol. 21(2), pages 197-206, March.
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