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Optimal Health Care Contract under Physician Agency

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  • Ching-to Albert MA

    ()
    (Department of Economics, Boston University.)

  • Philippe CHONÉ

    (CREST-LEI and CNRS UMR 2773)

Abstract

We model asymmetric information arising from physician agency and its effect on the design of payment and health care quantity. The physician aims to maximize a combination of physician profit and patient benefit. The degree of substitution between profit and patient benefit in the physician agency is the physician’s private information, as is the patient’s intrinsic valuation of treatment quantity. The equilibrium mechanism depends only on the physician agency parameter, and exhibits extensive pooling, with prescribed quantity and payment being insensitive to the agency characteristic or patient’s actual benefit. The optimal mechanism is interpreted as managed care where strict approval protocols are placed on treatments.

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Bibliographic Info

Paper provided by Boston University - Department of Economics in its series Boston University - Department of Economics - Working Papers Series with number WP2010-022.

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Length: 28 pages
Date of creation: Jan 2010
Date of revision:
Handle: RePEc:bos:wpaper:wp2010-022

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References

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  1. Frank, Richard G. & Glazer, Jacob & McGuire, Thomas G., 2000. "Measuring adverse selection in managed health care," Journal of Health Economics, Elsevier, vol. 19(6), pages 829-854, November.
  2. Ching-to Albert Ma, 1997. "Cost and Quality Incentives in Health Care: Altruistic Providers," Papers 0084, Boston University - Industry Studies Programme.
  3. Ellis, Randall P., 1998. "Creaming, skimping and dumping: provider competition on the intensive and extensive margins1," Journal of Health Economics, Elsevier, vol. 17(5), pages 537-555, October.
  4. Jullien, Bruno, 1997. "Participation Constraints in Adverse Selection Models," IDEI Working Papers 67, Institut d'Économie Industrielle (IDEI), Toulouse.
  5. 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.
  6. Rochaix, Lise, 1989. "Information asymmetry and search in the market for physicians' services," Journal of Health Economics, Elsevier, vol. 8(1), pages 53-84, March.
  7. Mark Dusheiko & Hugh Gravelle & Rowena Jacobs & Peter C Smith, . "The Effect of Budgets on Doctor Behaviour: Evidence From A Natural Experiment," Discussion Papers 03/04, Department of Economics, University of York.
  8. David Bardey & Jean-Charles Rochet, 2010. "Competition Among Health Plans: A Two-Sided Market Approach," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 19(2), pages 435-451, 06.
  9. 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.
  10. McGuire, Thomas G., 2000. "Physician agency," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 9, pages 461-536 Elsevier.
  11. Tim Besley & Maitreesh Ghatak, 2005. "Competition and incentives with motivated agents," LSE Research Online Documents on Economics 928, London School of Economics and Political Science, LSE Library.
  12. Dranove David & Spier Kathryn E., 2003. "A Theory of Utilization Review," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 2(1), pages 1-21, August.
  13. James R. Baumgardner, 1991. "The Interaction between Forms of Insurance Contract and Types of Technical Change in Medical Care," RAND Journal of Economics, The RAND Corporation, vol. 22(1), pages 36-53, Spring.
  14. Lewis, Tracy R. & Sappington, David E. M., 1989. "Countervailing incentives in agency problems," Journal of Economic Theory, Elsevier, vol. 49(2), pages 294-313, December.
  15. Keeler, Emmett B. & Carter, Grace & Newhouse, Joseph P., 1998. "A model of the impact of reimbursement schemes on health plan choice," Journal of Health Economics, Elsevier, vol. 17(3), pages 297-320, June.
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Cited by:
  1. Siciliani, Luigi, 2007. "Paying for Performance with Altruistic or Motivated Providers," CEPR Discussion Papers 6452, C.E.P.R. Discussion Papers.
  2. Godager, Geir & Wiesen, Daniel, 2011. "Profit or Patients' Health Benefit? Exploring the Heterogeneity in Physician Altruism," HERO On line Working Paper Series 2011:7, Oslo University, Health Economics Research Programme.
  3. Bardey, David & Canta, Chiara & Lozachmeur, Jean-Marie, 2010. "Health Care Providers Payments Regulation when Horizontal and Vertical Differentiation Matter," TSE Working Papers 10-164, Toulouse School of Economics (TSE).

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