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The Contribution of Managed Care to the Performance of Healthcare Systems - Evidence from Three Countries

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  • Johannes Schoder
  • Peter Zweifel
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    Abstract

    This paper applies the five standard economic performance criteria to gauge the contribu-tion of Managed Care (MC) to the performance of three healthcare systems, viz. Germany, the Netherlands, and Switzerland. The criteria are (1) matching of consumer preferences, (2) technical efficiency, (3) adaptive capacity, (4) dynamic efficiency, and (5) a rent-free distribution of income that provides incentives for producers to attain criteria (1) through (4). Being insurance-based, the German, Dutch, and Swiss healthcare systems comprise three contractual relationships that can be judged in the light of these criteria. The maximum contribution of MC to the performance of the healthcare system is found for the Netherlands followed by Switzerland. The Independent Practice Associations rep-resenting MC in the Netherlands, and the Health Maintenance Organizations representing MC in Switzerland score 15 respectively 6 out of 30 points. By way of contrast, the con-tribution of the Disease Management Programs to the performance of the German health-care system remains limited (3 out of 30 points).

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    Bibliographic Info

    Article provided by Swiss Society of Economics and Statistics (SSES) in its journal Swiss Journal of Economics and Statistics.

    Volume (Year): 144 (2008)
    Issue (Month): III (September)
    Pages: 477-493

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    Handle: RePEc:ses:arsjes:2008-iii-9

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    Related research

    Keywords: healthcare expenditure; managed care; performance; principal-agent relationship;

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    References

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    1. Frederik T. Schut & Wynand P. M. M. Van de Ven, 2005. "Rationing and competition in the Dutch health-care system," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages S59-S74.
    2. David M. Cutler & Mark McClellan & Joseph P. Newhouse, 2000. "How Does Managed Care Do It?," RAND Journal of Economics, The RAND Corporation, vol. 31(3), pages 526-548, Autumn.
    3. Wolfgang Greiner, 2005. "Health economic evaluation of disease management programs," The European Journal of Health Economics, Springer, vol. 6(3), pages 191-196, September.
    4. McClellan, Mark & Cutler, David & Newhous, Joseph P., 2000. "How Does Managed Care Do It?," Scholarly Articles 2643884, Harvard University Department of Economics.
    5. Lehmann, Hansjorg & Zweifel, Peter, 2004. "Innovation and risk selection in deregulated social health insurance," Journal of Health Economics, Elsevier, vol. 23(5), pages 997-1012, September.
    6. Stefan Felder, 2003. "Managed Care: Low Reputation but Most Effective," CESifo DICE Report, Ifo Institute for Economic Research at the University of Munich, vol. 1(3), pages 15-19, October.
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