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Network Incentives in Managed Health Care

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Author Info

  • Ma, C.-t.A.
  • McGuirem T.G.

Abstract

This paper introduces a theory of network incentives in managed health care. Participation in the plan's "network" confers an economic benefit on providers; in example, the plan expects compliance with its protocols. The network sets a target for the number of outpatient visits in an episode of care. A provider failing to satisfy the target may be penalized by the paln's attempt to direct patients to other providers within its network. There is an equilibrium in which every provider in the networlk uses the target.

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Bibliographic Info

Paper provided by Boston University - Department of Economics in its series Papers with number 94.

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Length: 30 pages
Date of creation: 1998
Date of revision:
Handle: RePEc:fth:bostec:94

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Postal: 270 Bay State Road, Boston, MA 02215
Phone: 617-353-4389
Fax: 617-353-444
Web page: http://www.bu.edu/econ/
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Related research

Keywords: HEALTH ; NETWORK ANALYSIS;

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Cited by:
  1. Tor Iversen & Ching-to Ma, 2011. "Market conditions and general practitioners’ referrals," International Journal of Health Care Finance and Economics, Springer, vol. 11(4), pages 245-265, December.
  2. Martha A. Starr & R. Forrest McCluer, 2014. "Prices and Quantities in Health Care Antitrust Damages," Working Papers 2014-03, American University, Department of Economics.
  3. Richard C. Lindrooth & Anthony T. Lo Sasso & Ithai Z. Lurie, 2006. "The effect of distance to provider on employee response to changes in mental health benefits," Health Economics, John Wiley & Sons, Ltd., vol. 15(10), pages 1133-1141.
  4. Audrey Boilley, 2013. "Duopoly Competition and Regulation in a Two-Sided Health Care Insurance Market with Product Differentiation," Working Papers 2013-02, CRESE.
  5. Newhouse, Joseph P. & McWilliams, J. Michael & Price, Mary & Huang, Jie & Fireman, Bruce & Hsu, John, 2013. "Do Medicare Advantage plans select enrollees in higher margin clinical categories?," Journal of Health Economics, Elsevier, vol. 32(6), pages 1278-1288.
  6. Bourgeon, Jean-Marc & Picard, Pierre & Pouyet, Jerome, 2008. "Providers' affiliation, insurance and collusion," Journal of Banking & Finance, Elsevier, vol. 32(1), pages 170-186, January.
  7. Colleen L. Barry & M. Susan Ridgely, 2008. "Mental health and substance abuse insurance parity for federal employees: How did health plans respond?," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 27(1), pages 155-170.

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