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Payment contracts in a preventive health care system: A perspective from Operations Management

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  • Yaesoubi, Reza
  • Roberts, Stephen D.

Abstract

We consider a health care system consisting of two noncooperative parties: a health purchaser (payer) and a health provider, where the interaction between the two parties is governed by a payment contract. We determine the contracts that coordinate the health purchaser–health provider relationship; i.e. the contracts that maximize the population's welfare while allowing each entity to optimize its own objective function. We show that under certain conditions (1) when the number of customers for a preventive medical intervention is verifiable, there exists a gate-keeping contract and a set of concave piecewise linear contracts that coordinate the system, and (2) when the number of customers is not verifiable, there exists a contract of bounded linear form and a set of incentive-feasible concave piecewise linear contracts that coordinate the system.

Suggested Citation

  • Yaesoubi, Reza & Roberts, Stephen D., 2011. "Payment contracts in a preventive health care system: A perspective from Operations Management," Journal of Health Economics, Elsevier, vol. 30(6), pages 1188-1196.
    • Handle: RePEc:eee:jhecon:v:30:y:2011:i:6:p:1188-1196
    DOI: 10.1016/j.jhealeco.2011.08.009
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    Cited by:

    1. Pengfei Guo & Christopher S. Tang & Yulan Wang & Ming Zhao, 2019. "The Impact of Reimbursement Policy on Social Welfare, Revisit Rate, and Waiting Time in a Public Healthcare System: Fee-for-Service Versus Bundled Payment," Service Science, INFORMS, vol. 21(1), pages 154-170, January.
    2. Elodie Adida & Hamed Mamani & Shima Nassiri, 2017. "Bundled Payment vs. Fee-for-Service: Impact of Payment Scheme on Performance," Management Science, INFORMS, vol. 63(5), pages 1606-1624, May.
    3. Sun, Huan & Wang, Haiyan, 2024. "Data-driven incentive mechanism design for chronic disease prevention from the perspective of government," European Journal of Operational Research, Elsevier, vol. 313(2), pages 652-668.
    4. Reza Mahjoub & Fredrik Ødegaard & Gregory S. Zaric, 2018. "Evaluation of a pharmaceutical risk‐sharing agreement when patients are screened for the probability of success," Health Economics, John Wiley & Sons, Ltd., vol. 27(1), pages 15-25, January.

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