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Physician Incentives In Managed Care Organizations Medical Practice Norms and the Quality of Care

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Author Info
David J. Cooper, James B. Rebitzer

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Abstract

This brief considers the interaction between physician incentive systems and product market competition in the delivery of medical services via managed care organizations. At the center of the analysis is the process by which health maintenance organizations (HMOs) assemble physician networks and the role these networks play in the competition for customers. The authors find that although physician practice styles respond to financial incentives, there is little evidence that HMO cost-containment incentives cause a discernable reduction in care quality. They propose a model of the managed care marketplace that solves for both physician incentive contracts and HMO product market strategies in an environment of extreme information asymmetry: physicians perceive the quality of care they offer perfectly and their patients do not perceive it at all.

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Paper provided by Levy Economics Institute, The in its series Economics Public Policy Brief Archive with number 70.

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Handle: RePEc:lev:levppb:70

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  1. David J. Cooper & James B. Rebitzer, 2002. "Managed Care, Physician Incentives, and Norms of Medical Practice: Racing to the Bottom or Pulling to the Top?," Economics Working Paper Archive 353, Levy Economics Institute, The. [Downloadable!]
  2. Daniel P. Kessler & Mark McClellan, 1996. "Do Doctors Practice Defensive Medicine?," NBER Working Papers 5466, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  3. Martin Gaynor & James B. Rebitzer & Lowell J. Taylor, 2001. "Incentives In HMOs," Economics Working Paper Archive 340, Levy Economics Institute, The. [Downloadable!]
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  4. Kessler, Daniel & McClellan, Mark, 1996. "Do Doctors Practice Defensive Medicine?," The Quarterly Journal of Economics, MIT Press, vol. 111(2), pages 353-90, May. [Downloadable!] (restricted)
  5. Daniel Altman & David M. Cutler & Richard Zeckhauser, 2000. "Enrollee Mix, Treatment Intensity, and Cost in Competing Indemnity and HMO Plans," NBER Working Papers 7832, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
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  6. 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.
  7. Phelps, Charles E, 1992. "Diffusion of Information in Medical Care," Journal of Economic Perspectives, American Economic Association, vol. 6(3), pages 23-42, Summer. [Downloadable!] (restricted)
  8. Kahneman, Daniel & Schkade, David & Sunstein, Cass R, 1998. "Shared Outrage and Erratic Awards: The Psychology of Punitive Damages," Journal of Risk and Uncertainty, Springer, vol. 16(1), pages 49-86, April. [Downloadable!] (restricted)
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This page was last updated on 2009-11-12.


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