IDEAS home Printed from
   My bibliography  Save this article

The Contribution of Managed Care to the Performance of Healthcare Systems - Evidence from Three Countries


  • Johannes Schoder
  • Peter Zweifel


This paper applies the five standard economic performance criteria to gauge the contribu-tion of Managed Care (MC) to the performance of three healthcare systems, viz. Germany, the Netherlands, and Switzerland. The criteria are (1) matching of consumer preferences, (2) technical efficiency, (3) adaptive capacity, (4) dynamic efficiency, and (5) a rent-free distribution of income that provides incentives for producers to attain criteria (1) through (4). Being insurance-based, the German, Dutch, and Swiss healthcare systems comprise three contractual relationships that can be judged in the light of these criteria. The maximum contribution of MC to the performance of the healthcare system is found for the Netherlands followed by Switzerland. The Independent Practice Associations rep-resenting MC in the Netherlands, and the Health Maintenance Organizations representing MC in Switzerland score 15 respectively 6 out of 30 points. By way of contrast, the con-tribution of the Disease Management Programs to the performance of the German health-care system remains limited (3 out of 30 points).

Suggested Citation

  • Johannes Schoder & Peter Zweifel, 2008. "The Contribution of Managed Care to the Performance of Healthcare Systems - Evidence from Three Countries," Swiss Journal of Economics and Statistics (SJES), Swiss Society of Economics and Statistics (SSES), vol. 144(III), pages 477-493, September.
  • Handle: RePEc:ses:arsjes:2008-iii-9

    Download full text from publisher

    File URL:
    Download Restriction: no

    References listed on IDEAS

    1. Wolfgang Greiner, 2005. "Health economic evaluation of disease management programs," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 6(3), pages 191-196, September.
    2. repec:ces:ifodic:v:1:y:2003:i:3:p:14567910 is not listed on IDEAS
    3. Stefan Felder, 2003. "Managed Care: Low Reputation but Most Effective," ifo DICE Report, ifo Institute - Leibniz Institute for Economic Research at the University of Munich, vol. 1(3), pages 15-19, October.
    4. Lehmann, Hansjorg & Zweifel, Peter, 2004. "Innovation and risk selection in deregulated social health insurance," Journal of Health Economics, Elsevier, vol. 23(5), pages 997-1012, September.
    5. Isabelle Huault & V. Perret & S. Charreire-Petit, 2007. "Management," Post-Print halshs-00337676, HAL.
    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. McClellan, Mark & Cutler, David & Newhous, Joseph P., 2000. "How Does Managed Care Do It?," Scholarly Articles 2643884, Harvard University Department of Economics.
    8. Frederik T. Schut & Wynand P. M. M. Van de Ven, 2005. "Rationing and competition in the Dutch health-care system," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages 59-74.
    Full references (including those not matched with items on IDEAS)

    More about this item


    healthcare expenditure; managed care; performance; principal-agent relationship;

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets


    Access and download statistics


    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:ses:arsjes:2008-iii-9. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Peter Steiner). General contact details of provider: .

    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.

    If CitEc recognized a reference but did not link an item in RePEc to it, you can help with 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.

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

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.