IDEAS home Printed from https://ideas.repec.org/p/tiu/tiucen/56362c38-f32c-45b9-93fc-1339aa175961.html
   My bibliography  Save this paper

Provider Competition and Over-Utilization in Health Care

Author

Listed:
  • Boone, J.

    (Tilburg University, Center For Economic Research)

  • Douven, R.C.M.H.

    (Tilburg University, Center For Economic Research)

Abstract

This paper compares the welfare effects of three ways in which health care can be organized: no competition (NC), competition for the market (CfM) and competition on the market (CoM) where the payer offers the optimal contract to providers in each case. We argue that each of these can be optimal depending on the contracting environment of a speciality. In particular, CfM is optimal in a clinical situation where the payer either has contractible information on provider quality or can enforce cost efficient protocols. If such contractible information is not available NC or CoM can be optimal depending on whether patients react to decentralized information on quality differences between providers and whether payer's and patients' preferences are aligned.
(This abstract was borrowed from another version of this item.)

Suggested Citation

  • Boone, J. & Douven, R.C.M.H., 2014. "Provider Competition and Over-Utilization in Health Care," Discussion Paper 2014-055, Tilburg University, Center for Economic Research.
  • Handle: RePEc:tiu:tiucen:56362c38-f32c-45b9-93fc-1339aa175961
    as

    Download full text from publisher

    File URL: https://pure.uvt.nl/ws/portalfiles/portal/4132148/2014_055.pdf
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Amitabh Chandra & Douglas O. Staiger, 2007. "Productivity Spillovers in Health Care: Evidence from the Treatment of Heart Attacks," Journal of Political Economy, University of Chicago Press, vol. 115(1), pages 103-140.
    2. Erik Schut & Stéphane Sorbe & Jens Høj, 2013. "Health Care Reform and Long-Term Care in the Netherlands," OECD Economics Department Working Papers 1010, OECD Publishing.
    3. Mougeot, Michel & Naegelen, Florence, 2005. "Hospital price regulation and expenditure cap policy," Journal of Health Economics, Elsevier, vol. 24(1), pages 55-72, January.
    4. Amitabh Chandra & Jonathan Skinner, 2012. "Technology Growth and Expenditure Growth in Health Care," Journal of Economic Literature, American Economic Association, vol. 50(3), pages 645-680, September.
    5. Boone, J. & Schottmuller, C., 2015. "Health Provider Networks, Quality and Costs," Discussion Paper 2015-005, Tilburg University, Center for Economic Research.
    6. van de Vijsel, Aart R. & Engelfriet, Peter M. & Westert, Gert P., 2011. "Rendering hospital budgets volume based and open ended to reduce waiting lists: Does it work?," Health Policy, Elsevier, vol. 100(1), pages 60-70, April.
    7. Baron, David P & Myerson, Roger B, 1982. "Regulating a Monopolist with Unknown Costs," Econometrica, Econometric Society, vol. 50(4), pages 911-930, July.
    8. Jeffrey Clemens & Joshua D. Gottlieb, 2014. "Do Physicians' Financial Incentives Affect Medical Treatment and Patient Health?," American Economic Review, American Economic Association, vol. 104(4), pages 1320-1349, April.
    9. David Cutler, 2006. "The Economics of Health System Payment," De Economist, Springer, vol. 154(1), pages 1-18, March.
    10. Chandra, Amitabh & Cutler, David & Song, Zirui, 2011. "Who Ordered That? The Economics of Treatment Choices in Medical Care," Handbook of Health Economics, in: Mark V. Pauly & Thomas G. Mcguire & Pedro P. Barros (ed.), Handbook of Health Economics, volume 2, chapter 0, pages 397-432, Elsevier.
    11. Eric Maskin, 1999. "Nash Equilibrium and Welfare Optimality," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 66(1), pages 23-38.
    12. Robert G. Evans, 1974. "Supplier-Induced Demand: Some Empirical Evidence and Implications," International Economic Association Series, in: Mark Perlman (ed.), The Economics of Health and Medical Care, chapter 10, pages 162-173, Palgrave Macmillan.
    13. Chalkley, Martin & Malcomson, James M, 1998. "Contracting for Health Services with Unmonitored Quality," Economic Journal, Royal Economic Society, vol. 108(449), pages 1093-1110, July.
    14. Pope, Devin G., 2009. "Reacting to rankings: Evidence from "America's Best Hospitals"," Journal of Health Economics, Elsevier, vol. 28(6), pages 1154-1165, December.
    15. Giuffrida, Antonio & Gravelle, Hugh, 2001. "Inducing or restraining demand: the market for night visits in primary care," Journal of Health Economics, Elsevier, vol. 20(5), pages 755-779, September.
    16. Chalkley, Martin & Malcomson, James M., 2000. "Government purchasing of health services," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 15, pages 847-890, Elsevier.
    17. Schut, Frederik T. & Varkevisser, Marco, 2013. "Tackling hospital waiting times: The impact of past and current policies in the Netherlands," Health Policy, Elsevier, vol. 113(1), pages 127-133.
    18. Jean-Jacques Laffont & Jean Tirole, 1993. "A Theory of Incentives in Procurement and Regulation," MIT Press Books, The MIT Press, edition 1, volume 1, number 0262121743, December.
    19. Martin Gaynor & Deborah Haas-Wilson & William B. Vogt, 2000. "Are Invisible Hands Good Hands? Moral Hazard, Competition, and the Second-Best in Health Care Markets," Journal of Political Economy, University of Chicago Press, vol. 108(5), pages 992-1005, October.
    20. Palfrey, Thomas R & Srivastava, Sanjay, 1991. "Nash Implementation Using Undominated Strategies," Econometrica, Econometric Society, vol. 59(2), pages 479-501, March.
    21. Mark V. Pauly & Thomas G. Mcguire & Pedro P. Barros (ed.), 2011. "Handbook of Health Economics," Handbook of Health Economics, Elsevier, volume 2, number 2.
    22. Mougeot, Michel & Naegelen, Florence, 2005. "Hospital price regulation and expenditure cap policy," Journal of Health Economics, Elsevier, vol. 24(1), pages 55-72, January.
    23. Dranove, David & Shanley, Mark & White, William D, 1993. "Price and Concentration in Hospital Markets: The Switch from Patient-Driven to Payer-Driven Competition," Journal of Law and Economics, University of Chicago Press, vol. 36(1), pages 179-204, April.
    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. Boone, Jan, 2019. "Health provider networks with private contracts: Is there under-treatment in narrow networks?," Journal of Health Economics, Elsevier, vol. 67(C).
    2. Albrecht, Martin, 2018. "Potenziale für mehr Wettbewerb im Gesundheitswesen: Expertise," Working Papers 05/2018, German Council of Economic Experts / Sachverständigenrat zur Begutachtung der gesamtwirtschaftlichen Entwicklung.

    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. Boone, J. & Douven, R.C.M.H., 2014. "Provider Competition and Over-Utilization in Health Care," Other publications TiSEM 56362c38-f32c-45b9-93fc-1, Tilburg University, School of Economics and Management.
    2. Jan Boone & Rudy Douven, 2014. "Provider competition and over-utilization in health care," CPB Discussion Paper 275.rdf, CPB Netherlands Bureau for Economic Policy Analysis.
    3. Jan Boone & Rudy Douven, 2014. "Provider competition and over-utilization in health care," CPB Discussion Paper 275, CPB Netherlands Bureau for Economic Policy Analysis.
    4. Siciliani, Luigi, 2006. "Selection of treatment under prospective payment systems in the hospital sector," Journal of Health Economics, Elsevier, vol. 25(3), pages 479-499, May.
    5. Rudy Douven & Remco Mocking & Ilaria Mosca, 2012. "The Effect of Physician Fees and Density Differences on Regional Variation in Hospital Treatments," CPB Discussion Paper 208, CPB Netherlands Bureau for Economic Policy Analysis.
    6. Miraldo, Marisa & Siciliani, Luigi & Street, Andrew, 2011. "Price adjustment in the hospital sector," Journal of Health Economics, Elsevier, vol. 30(1), pages 112-125, January.
    7. Beitia, Arantza, 2003. "Hospital quality choice and market structure in a regulated duopoly," Journal of Health Economics, Elsevier, vol. 22(6), pages 1011-1036, November.
    8. Elin Johanna Gudrun Hafsteinsdottir & Luigi Siciliani, 2010. "DRG prospective payment systems: refine or not refine?," Health Economics, John Wiley & Sons, Ltd., vol. 19(10), pages 1226-1239, October.
    9. Dominic Coey, 2013. "Physician Incentives and Treatment Choices in Heart Attack Management," Discussion Papers 12-027, Stanford Institute for Economic Policy Research.
    10. Rudy Douven & Minke Remmerswaal & Tobias Vervliet, 2021. "Payment schemes and treatment responses after a demand shock in mental health care," Health Economics, John Wiley & Sons, Ltd., vol. 30(12), pages 2956-2973, December.
    11. Kuhn, Michael & Siciliani, Luigi, 2013. "Manipulation and auditing of public sector contracts," European Journal of Political Economy, Elsevier, vol. 32(C), pages 251-267.
    12. Kuhn, Michael & Siciliani, Luigi, 2008. "Upcoding and Optimal Auditing in Health Care (or The economics of DRG creep)," CEPR Discussion Papers 6689, C.E.P.R. Discussion Papers.
    13. Amitabh Chandra & Amy Finkelstein & Adam Sacarny & Chad Syverson, 2016. "Health Care Exceptionalism? Performance and Allocation in the US Health Care Sector," American Economic Review, American Economic Association, vol. 106(8), pages 2110-2144, August.
    14. Maynou, L. & McGuire, A. & Serra-Sastre, V., 2019. "Exploring the Impact of New Medical Technology on Workforce Planning," Working Papers 19/07, Department of Economics, City University London.
    15. Jeffrey Clemens & Joshua D. Gottlieb & Jeffrey Hicks, 2021. "How Would Medicare for All Affect Health System Capacity? Evidence from Medicare for Some," Tax Policy and the Economy, University of Chicago Press, vol. 35(1), pages 225-262.
    16. Wozny, Florian, 2020. "Hospital Resources: Persistent Reallocation under Price Changes," IZA Discussion Papers 13256, Institute of Labor Economics (IZA).
    17. Amitabh Chandra & Amy Finkelstein & Adam Sacarny & Chad Syverson, 2013. "Healthcare Exceptionalism? Productivity and Allocation in the U.S. Healthcare Sector," NBER Working Papers 19200, National Bureau of Economic Research, Inc.
    18. Oddvar Kaarboe & Luigi Siciliani, 2011. "Multi‐tasking, quality and pay for performance," Health Economics, John Wiley & Sons, Ltd., vol. 20(2), pages 225-238, February.
    19. Grimm Veronika & Zöttl Gregor, 2010. "Price Regulation under Demand Uncertainty," The B.E. Journal of Theoretical Economics, De Gruyter, vol. 10(1), pages 1-34, June.
    20. Khalil, Fahad & Lawarree, Jacques, 2001. "Catching the agent on the wrong foot: ex post choice of monitoring," Journal of Public Economics, Elsevier, vol. 82(3), pages 327-347, December.

    More about this item

    Keywords

    competition; health care; selective contracting; over-utilization; mechanism design;
    All these keywords.

    JEL classification:

    • D82 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Asymmetric and Private Information; Mechanism Design
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • L5 - Industrial Organization - - Regulation and Industrial Policy

    NEP fields

    This paper has been announced in the following NEP Reports:

    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:tiu:tiucen:56362c38-f32c-45b9-93fc-1339aa175961. 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: Richard Broekman (email available below). General contact details of provider: http://center.uvt.nl .

    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.