IDEAS home Printed from https://ideas.repec.org/a/oup/ecinqu/v40y2002i3p348-365.html
   My bibliography  Save this article

Provider Selection, Bargaining, and Utilization Management in Managed Care

Author

Listed:
  • Richard C. Lindrooth

    (Center for Health Industry Market Economics, Northwestern University, 2001 Sheridan Road, Evanston, IL 60208.)

  • Edward C. Norton

    (Health Policy and Administration, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599.)

  • Barbara Dickey

    (Department of Psychiatry, Cambridge Hospital, Harvard Medical School, Cambridge, MA 02139.)

Abstract

Managed care controls cost through a combination of provider selection, bargaining, and utilization management. Provider selection will reduce expenditures if patients are funneled to efficient providers. Bargaining will reduce expenditures through lower rates. Utilization management will reduce expenditures if providers reduce treatment intensity due to monitoring. We estimate that about 30% of the reduction in inpatient expenditures in a mental health carve-out was due to provider selection, 5% was due to bargaining, and the remaining 65% was due to utilization management. We find that both the provider selection and utilization management effects were likely to be welfare improving. Copyright 2002, Oxford University Press.

Suggested Citation

  • Richard C. Lindrooth & Edward C. Norton & Barbara Dickey, 2002. "Provider Selection, Bargaining, and Utilization Management in Managed Care," Economic Inquiry, Western Economic Association International, vol. 40(3), pages 348-365, July.
    • Handle: RePEc:oup:ecinqu:v:40:y:2002:i:3:p:348-365
    as

    Download full text from publisher

    To our knowledge, this item is not available for download. To find whether it is available, there are three options:
    1. Check below whether another version of this item is available online.
    2. Check on the provider's web page whether it is in fact available.
    3. Perform a search for a similarly titled item that would be available.

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Leo Turcotte & John Robst & Solomon Polachek, 2006. "Medical interventions among pregnant women in fee-for-service and managed care insurance: a propensity score analysis," Applied Economics, Taylor & Francis Journals, vol. 38(13), pages 1513-1525.
    2. Atwood, Alicia & Lo Sasso, Anthony T., 2016. "The effect of narrow provider networks on health care use," Journal of Health Economics, Elsevier, vol. 50(C), pages 86-98.
    3. Nigam, Amit, 2012. "The effects of institutional change on geographic variation and health services use in the USA," Social Science & Medicine, Elsevier, vol. 74(3), pages 323-331.
    4. Hai Fang & John Rizzo, 2010. "Has the influence of managed care waned? Evidence from the market for physician services," International Journal of Health Economics and Management, Springer, vol. 10(1), pages 85-103, March.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:oup:ecinqu:v:40:y:2002:i:3:p:348-365. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no bibliographic references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Oxford University Press (email available below). General contact details of provider: https://edirc.repec.org/data/weaaaea.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.