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Budgetbereinigung zwischen Kollektiv- und Selektivvertrag: ökonomische Aspekte aus wettbewerblicher Sicht / Selective Contracting and Collectively Financed Fund: The Way of Appropriate Adjustment


  • Zerth Jürgen

    () (International Dialog College and Research Institute Fürth (IDC), Diakonie Neuendettelsau, 91564 Neuendettelsau, Germany, sowie Forschungsstelle Sozialrecht und Gesundheitsökonomie, Universität Bayreuth, 95440 Bayreuth, Germany)

  • Daum Stefanie

    () (Lehrstuhl für Wirtschaftspolitik, Universität Erlangen-Nürnberg, 90403 Nürnberg, Germany)


The extraction of a selective contract from a collectively financed fund needs an appropriate method of adjustment. This is necessary as long as the fund guarantees basic benefits, irrespective of the contractual form of service provision. In this context externalities arise which may not be internalized by the partner of a selective contract.We look at externalities in the context of a collectively financed fund where insurers and health care providers can contract forms of managed care that need an adjustment scheme.We show that in a first-best static world, unique reimbursement schemes between collective and selective contracts are appropriate. From a dynamic perspective problems of externalities between collective and selective contracts increase due to the requirement of an enduring commitment scheme between the health care providers and the cost-payers. But some simple form of cost-sharing ideas in which the patient is also involved can help to achieve a pareto-optimal equilibrium. This commitment strategy will be easier to organise if the selective contract is connected with a process innovation. Altogether, the dynamic commitment strategy may only work if health care providers as well as cost-payers compete actively.

Suggested Citation

  • Zerth Jürgen & Daum Stefanie, 2012. "Budgetbereinigung zwischen Kollektiv- und Selektivvertrag: ökonomische Aspekte aus wettbewerblicher Sicht / Selective Contracting and Collectively Financed Fund: The Way of Appropriate Adjustment," Journal of Economics and Statistics (Jahrbuecher fuer Nationaloekonomie und Statistik), De Gruyter, vol. 232(4), pages 460-481, August.
  • Handle: RePEc:jns:jbstat:v:232:y:2012:i:4:p:460-481

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    References listed on IDEAS

    1. Gaynor, Martin & Vogt, William B., 2000. "Antitrust and competition in health care markets," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.),Handbook of Health Economics, edition 1, volume 1, chapter 27, pages 1405-1487, Elsevier.
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    7. Börsch-Supan Axel, 2007. "Vertragswettbewerb im Gesundheitswesen / Double-sided Competition for the German Health Care Market," Journal of Economics and Statistics (Jahrbuecher fuer Nationaloekonomie und Statistik), De Gruyter, vol. 227(5-6), pages 451-465, October.
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