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Overcoming resistance against managed care – insights from a bargaining model

Author

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  • Andree Ehlert

    (Leuphana University of Lueneburg)

  • Thomas Wein

    (Leuphana University of Lueneburg)

  • Peter Zweifel

    (Leuphana University of Lueneburg)

Abstract

Recent healthcare reforms have sought to increase efficiency by introducing managed care (MC) while respecting consumer preferences by admitting choice between MC and conventional care. This article proposes an institutional change designed to let German consumers choose between the two settings through directing payments from the Federal Health Fund to social health insurers (SHIs) or to specialized MC organizations (MCOs). To gauge the chance of success of this reform, a game involving a SHI, a MCO, and a representative insured (RI) is analyzed. In a “three-player/three-cake” game the coalitions {SHI, MCO}, {MCO, RI}, and {SHI, RI} can form. Players’ possibility to switch between coalitions creates new outside options, causing the conventional bilateral Nash bargaining solution to be replaced by the so-called von Neumann-Morgenstern triple. These triples are compared to the status quo (where the RI has no threat potential) and related to institutional conditions characterizing Germany, the Netherlands, and Switzerland.

Suggested Citation

  • Andree Ehlert & Thomas Wein & Peter Zweifel, 2017. "Overcoming resistance against managed care – insights from a bargaining model," Health Economics Review, Springer, vol. 7(1), pages 1-15, December.
    • Handle: RePEc:spr:hecrev:v:7:y:2017:i:1:d:10.1186_s13561-017-0156-4
    DOI: 10.1186/s13561-017-0156-4
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    References listed on IDEAS

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    2. Zweifel, Peter, 2021. "Innovation in health care through information technology (IT): The role of incentives," Social Science & Medicine, Elsevier, vol. 289(C).

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    More about this item

    Keywords

    Managed care; Game theory; Multilateral Nash bargaining; Health insurance; Consumer choice; Healthcare reform; Germany; The Netherlands; Switzerland;
    All these keywords.

    JEL classification:

    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • D02 - Microeconomics - - General - - - Institutions: Design, Formation, Operations, and Impact
    • C72 - Mathematical and Quantitative Methods - - Game Theory and Bargaining Theory - - - Noncooperative Games

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