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Die Ausgestaltung von Versorgungsverträgen: Eine vertragstheoretische Analyse / A Contract Theory Approach to Health Care Contracting

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  • Mühlbacher Axel

    () (Institut Gesundheitsökonomie und Medizinmanagement, Hochschule Neubrandenburg, Brodaer Straße 2, 17033 Neubrandenburg, Germany)

Abstract

Transaction costs are an obstacle to the efficient operation of selective contracting. Health care delivery systems (§140 a-d SGB V) and selective contracting between networks of service providers and purchasers are advocated as an effective method to improve the performance of the German health care system. The problems of measurability, motivation associated with specific production of health care services forms a stronger regulatory environment. Contracting mechanisms should be analysed before purchasers can rely on obtaining these services from the selective contracting sector. This paper focuses on the theories from new institutional economics to analyze the policies of competitive contracting in the presence of asymmetric information, uncertainty and the inability to write complete contingent contracts. It is crucial, that both parties agree on the avoidance of endogenous risks and the procedures with unforeseeable contingencies (exogenous risks). Strategic behavior because of moral hazard and hold up situations is referred to endogenous risk. Uncertainty based on contingency, error and change of utilization are identified as exogenous risks. In order to control these risks structured renegotiations and risk-sharing and shared-saving arrangements should be scheduled.

Suggested Citation

  • Mühlbacher Axel, 2007. "Die Ausgestaltung von Versorgungsverträgen: Eine vertragstheoretische Analyse / A Contract Theory Approach to Health Care Contracting," Journal of Economics and Statistics (Jahrbuecher fuer Nationaloekonomie und Statistik), De Gruyter, vol. 227(5-6), pages 765-786, October.
  • Handle: RePEc:jns:jbstat:v:227:y:2007:i:5-6:p:765-786
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    References listed on IDEAS

    as
    1. Hart, Oliver D & Moore, John, 1988. "Incomplete Contracts and Renegotiation," Econometrica, Econometric Society, vol. 56(4), pages 755-785, July.
    2. Hart, Oliver & Moore, John, 1990. "Property Rights and the Nature of the Firm," Journal of Political Economy, University of Chicago Press, vol. 98(6), pages 1119-1158, December.
    3. Aghion, Philippe & Dewatripont, Mathias & Rey, Patrick, 1994. "Renegotiation Design with Unverifiable Information," Econometrica, Econometric Society, vol. 62(2), pages 257-282, March.
    4. Tai-Yeong Chung, 1991. "Incomplete Contracts, Specific Investments, and Risk Sharing," Review of Economic Studies, Oxford University Press, vol. 58(5), pages 1031-1042.
    5. Ellis, Randall P. & McGuire, Thomas G., 1990. "Optimal payment systems for health services," Journal of Health Economics, Elsevier, vol. 9(4), pages 375-396, December.
    6. Randall P. Ellis & Thomas G. McGuire, 1993. "Supply-Side and Demand-Side Cost Sharing in Health Care," Journal of Economic Perspectives, American Economic Association, vol. 7(4), pages 135-151, Fall.
    7. Selden, Thomas M., 1990. "A model of capitation," Journal of Health Economics, Elsevier, vol. 9(4), pages 397-409, December.
    8. Michael Spence, 1973. "Job Market Signaling," The Quarterly Journal of Economics, Oxford University Press, vol. 87(3), pages 355-374.
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