IDEAS home Printed from https://ideas.repec.org/a/wly/hlthec/v17y2008i3p299-316.html
   My bibliography  Save this article

Consumer channeling by health insurers: natural experiments with preferred providers in the Dutch pharmacy market

Author

Listed:
  • Lieke H. H. M. Boonen
  • Frederik T. Schut
  • Xander Koolman

Abstract

Consumer channeling is an important element in the insurer–provider bargaining process. Health insurers can influence provider choice by offering insurance contracts with restricted provider networks. Alternatively, they can offer contracts with unrestricted access and use incentives to motivate consumers to visit preferred providers. Little is known, however, about the effectiveness of this alternative strategy of consumer channeling. Using data from two natural experiments in the Dutch pharmacy market, we examine how consumers respond to incentives used by health insurers to influence their choice of provider. We find that consumers are sensitive to rather small incentives and that temporary incentives may sort a long‐term effect on provider choice. In addition, we find that both consumer and provider characteristics determine whether consumers are willing to switch to preferred pharmacies. Copyright © 2007 John Wiley & Sons, Ltd.

Suggested Citation

  • Lieke H. H. M. Boonen & Frederik T. Schut & Xander Koolman, 2008. "Consumer channeling by health insurers: natural experiments with preferred providers in the Dutch pharmacy market," Health Economics, John Wiley & Sons, Ltd., vol. 17(3), pages 299-316, March.
  • Handle: RePEc:wly:hlthec:v:17:y:2008:i:3:p:299-316
    DOI: 10.1002/hec.1265
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hec.1265
    Download Restriction: no

    File URL: https://libkey.io/10.1002/hec.1265?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Burns, Lawton R. & Wholey, Douglas R., 1992. "The impact of physician characteristics in conditional choice models for hospital care," Journal of Health Economics, Elsevier, vol. 11(1), pages 43-62, May.
    2. Strombom, Bruce A. & Buchmueller, Thomas C. & Feldstein, Paul J., 2002. "Switching costs, price sensitivity and health plan choice," Journal of Health Economics, Elsevier, vol. 21(1), pages 89-116, January.
    3. Machiel van Dijk & Marc Pomp & Rudy Douven, 2006. "Consumer price sensitivity in health insurance," CPB Discussion Paper 56, CPB Netherlands Bureau for Economic Policy Analysis.
    4. Hausman, Jerry & McFadden, Daniel, 1984. "Specification Tests for the Multinomial Logit Model," Econometrica, Econometric Society, vol. 52(5), pages 1219-1240, September.
    5. Mandy Ryan & Jenny Hughes, 1997. "Using Conjoint Analysis to Assess Women's Preferences for Miscarriage Management," Health Economics, John Wiley & Sons, Ltd., vol. 6(3), pages 261-273, May.
    6. Roger Feldman & Michael Finch & Bryan Dowd & Steven Cassou, 1989. "The Demand for Employment-Based Health Insurance Plans," Journal of Human Resources, University of Wisconsin Press, vol. 24(1), pages 115-142.
    7. David Madden & Anne Nolan & Brian Nolan, 2005. "GP reimbursement and visiting behaviour in Ireland," Health Economics, John Wiley & Sons, Ltd., vol. 14(10), pages 1047-1060, October.
    8. Van de ven, Wynand P.M.M. & Ellis, Randall P., 2000. "Risk adjustment in competitive health plan markets," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 14, pages 755-845, Elsevier.
    9. Buchmueller, Thomas C. & Feldstein, Paul J., 1997. "The effect of price on switching among health plans," Journal of Health Economics, Elsevier, vol. 16(2), pages 231-247, April.
    10. Melnick, Glenn A. & Zwanziger, Jack & Bamezai, Anil & Pattison, Robert, 1992. "The effects of market structure and bargaining position on hospital prices," Journal of Health Economics, Elsevier, vol. 11(3), pages 217-233, October.
    11. Lamers, Leida M. & van Vliet, Rene C. J. A., 2004. "The Pharmacy-based Cost Group model: validating and adjusting the classification of medications for chronic conditions to the Dutch situation," Health Policy, Elsevier, vol. 68(1), pages 113-121, April.
    12. Town, Robert & Vistnes, Gregory, 2001. "Hospital competition in HMO networks," Journal of Health Economics, Elsevier, vol. 20(5), pages 733-753, September.
    13. Staten, Michael & Dunkelberg, William & Umbeck, John, 1987. "Market share and the illusion of power : Can blue cross force hospitals to discount?," Journal of Health Economics, Elsevier, vol. 6(1), pages 43-58, March.
    14. Samuelson, William & Zeckhauser, Richard, 1988. "Status Quo Bias in Decision Making," Journal of Risk and Uncertainty, Springer, vol. 1(1), pages 7-59, March.
    15. Propper, Carol, 2000. "The demand for private health care in the UK," Journal of Health Economics, Elsevier, vol. 19(6), pages 855-876, November.
    16. Zweifel, Peter & Manning, Willard G., 2000. "Moral hazard and consumer incentives in health care," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 8, pages 409-459, Elsevier.
    17. Ryan, Mandy & Netten, Ann & Skatun, Diane & Smith, Paul, 2006. "Using discrete choice experiments to estimate a preference-based measure of outcome--An application to social care for older people," Journal of Health Economics, Elsevier, vol. 25(5), pages 927-944, September.
    18. Harris, Katherine & Schultz, Jennifer & Feldman, Roger, 2002. "Measuring consumer perceptions of quality differences among competing health benefit plans," Journal of Health Economics, Elsevier, vol. 21(1), pages 1-17, January.
    19. Leemore Dafny & David Dranove, 2008. "Do report cards tell consumers anything they don't already know? The case of Medicare HMOs," RAND Journal of Economics, RAND Corporation, vol. 39(3), pages 790-821, September.
    20. Farrar, Shelley & Ryan, Mandy & Ross, Donald & Ludbrook, Anne, 2000. "Using discrete choice modelling in priority setting: an application to clinical service developments," Social Science & Medicine, Elsevier, vol. 50(1), pages 63-75, January.
    21. Anne Beeson Royalty & Neil Solomon, 1999. "Health Plan Choice: Price Elasticities in a Managed Competition Setting," Journal of Human Resources, University of Wisconsin Press, vol. 34(1), pages 1-41.
    22. Pauly, Mark V., 1987. "Monopsony power in health insurance: thinking straight while standing on your head," Journal of Health Economics, Elsevier, vol. 6(1), pages 73-81, March.
    23. Anil Bamezai & Glenn A. Melnick & Joyce M. Mann & Jack Zwanziger, 2003. "Hospital selective contracting without consumer choice: What can we learn from Medi-Cal?," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 22(1), pages 65-84.
    24. Chernew, Michael & Gowrisankaran, Gautam & McLaughlin, Catherine & Gibson, Teresa, 2004. "Quality and employers' choice of health plans," Journal of Health Economics, Elsevier, vol. 23(3), pages 471-492, May.
    25. Hodgkin, Dominic, 1996. "Specialized service offerings and patients' choice of hospital: The case of cardiac catheterization," Journal of Health Economics, Elsevier, vol. 15(3), pages 305-332, June.
    26. Alan T. Sorensen, 2003. "Insurer‐hospital bargaining: negotiated discounts in post‐deregulation connecticut," Journal of Industrial Economics, Wiley Blackwell, vol. 51(4), pages 469-490, December.
    27. 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, September.
    Full references (including those not matched with items on IDEAS)

    Citations

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


    Cited by:

    1. van der Hulst, Frank J.P. & Holst, Laurens & Brabers, Anne E.M. & de Jong, Judith D., 2022. "To what degree are health insurance enrollees in the Netherlands aware of the restrictive conditions attached to their policies?," Health Policy, Elsevier, vol. 126(7), pages 693-703.
    2. Bes, Romy E. & Curfs, Emile C. & Groenewegen, Peter P. & de Jong, Judith D., 2017. "Selective contracting and channelling patients to preferred providers: A scoping review," Health Policy, Elsevier, vol. 121(5), pages 504-514.
    3. Heinemann, Stephanie & Leiber, Simone & Greß, Stefan, 2013. "Managed competition in the Netherlands—A qualitative study," Health Policy, Elsevier, vol. 109(2), pages 113-121.
    4. France R. M. Portrait & Onno van der Galiën & Bernard Van den Berg, 2016. "Measuring Healthcare Providers' Performances Within Managed Competition Using Multidimensional Quality and Cost Indicators," Health Economics, John Wiley & Sons, Ltd., vol. 25(4), pages 408-423, April.
    5. Lieke Boonen & Frederik Schut & Bas Donkers & Xander Koolman, 2009. "Which preferred providers are really preferred? Effectiveness of insurers’ channeling incentives on pharmacy choice," International Journal of Health Economics and Management, Springer, vol. 9(4), pages 347-366, December.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Lieke Boonen & Frederik Schut & Bas Donkers & Xander Koolman, 2009. "Which preferred providers are really preferred? Effectiveness of insurers’ channeling incentives on pharmacy choice," International Journal of Health Economics and Management, Springer, vol. 9(4), pages 347-366, December.
    2. van den Berg, Bernard & Van Dommelen, Paula & Stam, Piet & Laske-Aldershof, Trea & Buchmueller, Tom & Schut, Frederik T., 2008. "Preferences and choices for care and health insurance," Social Science & Medicine, Elsevier, vol. 66(12), pages 2448-2459, June.
    3. Martin Gaynor & Deborah Haas-Wilson, 1999. "Change, Consolidation, and Competition in Health Care Markets," Journal of Economic Perspectives, American Economic Association, vol. 13(1), pages 141-164, Winter.
    4. Gaynor, Martin & Town, Robert J., 2011. "Competition in Health Care Markets," Handbook of Health Economics, in: Mark V. Pauly & Thomas G. Mcguire & Pedro P. Barros (ed.), Handbook of Health Economics, volume 2, chapter 0, pages 499-637, Elsevier.
    5. Abraham, Jean M. & Feldman, Roger & Carlin, Caroline & Christianson, Jon, 2006. "The effect of quality information on consumer health plan switching: Evidence from the Buyers Health Care Action Group," Journal of Health Economics, Elsevier, vol. 25(4), pages 762-781, July.
    6. Rudy Douven & Marco Ligthart & H. Lieverdink & I. Vermeulen, 2007. "Measuring annual price elasticities in Dutch health insurance; a new method," CPB Discussion Paper 90.rdf, CPB Netherlands Bureau for Economic Policy Analysis.
    7. Sinaiko, Anna D. & Hirth, Richard A., 2011. "Consumers, health insurance and dominated choices," Journal of Health Economics, Elsevier, vol. 30(2), pages 450-457, March.
    8. Buchmueller, Thomas, 2006. "Price and the health plan choices of retirees," Journal of Health Economics, Elsevier, vol. 25(1), pages 81-101, January.
    9. Brigitte Dormont & Pierre-Yves Geoffard & Karine Lamiraud, 2012. "Assurance maladie en Suisse : les assurances supplémentaires nuisent-elles à la concurrence sur l'assurance de base ?," Économie et Statistique, Programme National Persée, vol. 455(1), pages 71-87.
    10. R. Halbersma & M. Mikkers & E. Motchenkova & I. Seinen, 2011. "Market structure and hospital–insurer bargaining in the Netherlands," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 12(6), pages 589-603, December.
    11. Karolin Becker & Peter Zweifel, 2008. "Age and Choice in Health Insurance," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 1(1), pages 27-40, January.
    12. Marcus C. Christiansen & Martin Eling & Jan-Philipp Schmidt & Lorenz Zirkelbach, 2016. "Who is Changing Health Insurance Coverage? Empirical Evidence on Policyholder Dynamics," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 83(2), pages 269-300, June.
    13. Rudy Douven & Marco Ligthart & H. Lieverdink & I. Vermeulen, 2007. "Measuring annual price elasticities in Dutch health insurance; a new method," CPB Discussion Paper 90, CPB Netherlands Bureau for Economic Policy Analysis.
    14. Marco Varkevisser & Stéphanie Geest & Frederik Schut, 2010. "Assessing hospital competition when prices don’t matter to patients: the use of time-elasticities," International Journal of Health Economics and Management, Springer, vol. 10(1), pages 43-60, March.
    15. Bünnings, Christian & Schmitz, Hendrik & Tauchmann, Harald & Ziebarth, Nicolas R., 2015. "How health plan enrollees value prices relative to supplemental benefits and service quality," FAU Discussion Papers in Economics 02/2015, Friedrich-Alexander University Erlangen-Nuremberg, Institute for Economics.
    16. David Bardey & Jean‐Charles Rochet, 2010. "Competition Among Health Plans: A Two‐Sided Market Approach," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 19(2), pages 435-451, June.
    17. Christian Bünnings & Hendrik Schmitz & Harald Tauchmann & Nicolas R. Ziebarth, 2015. "How Health Plan Enrollees Value Prices Relative to Supplemental Benefits and Service Quality," Ruhr Economic Papers 0545, Rheinisch-Westfälisches Institut für Wirtschaftsforschung, Ruhr-Universität Bochum, Universität Dortmund, Universität Duisburg-Essen.
    18. Conor Keegan & Conor Teljeur & Brian Turner & Steve Thomas, 2019. "Switching benefits and costs in the Irish health insurance market: an analysis of consumer surveys," International Journal of Health Economics and Management, Springer, vol. 19(1), pages 15-32, March.
    19. 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.
    20. M. Kate Bundorf & Jonathan Levin & Neale Mahoney, 2012. "Pricing and Welfare in Health Plan Choice," American Economic Review, American Economic Association, vol. 102(7), pages 3214-3248, December.

    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:wly:hlthec:v:17:y:2008:i:3:p:299-316. 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.

    If CitEc recognized a bibliographic 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.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www3.interscience.wiley.com/cgi-bin/jhome/5749 .

    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.