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Research article summary:
Multiple payers, commonality and free-riding in health care: Medicare and private payers.
Abstract Extract:
Managed health care plans and providers in the US and elsewhere sell their services to multiple payers. For example, the three largest groups of purchasers from health plans in the US are employers, Medicaid plans, and Medicare, with the first two ... (Full abstract text below) Published 2002Nov
in Journal: J Health Econ
(Language : eng)
Full Pubmed Extract
This information was retrieved, real-time, on your behalf from the public area of the Pubmed website:
1. J Health Econ.
2002 Nov;21(6):1049-69
Multiple payers, commonality and free-riding in health care: Medicare and private payers.
Glazer J, McGuire TG
Tel Aviv University, Israel.
Managed health care plans and providers in the US and elsewhere sell their services to multiple payers. For example, the three largest groups of purchasers from health plans in the US are employers, Medicaid plans, and Medicare, with the first two accounting for over 90% of the total enrollees. In the case of hospitals, Medicare is the largest buyer, but it alone only accounts for 40% of the total payments. While payers have different objectives and use different contracting practices, the plans and providers set some elements of the quality in common for all payers. In this paper, we study the interactions between a public payer, modeled on Medicare, which sets a price and takes any willing provider, a private payer, which limits providers and pays a price on the basis of quality, and a provider/plan, in the presence of shared elements of quality. The provider compromises in response to divergent incentives from payers. The private sector dilutes Medicare payment initiatives, and may, under some circumstances, repair Medicare payment policy mistakes. If Medicare behaves strategically in the presence of private payers, it can free-ride on the private payer and set its prices too low. Our paper has many testable implications, including a new hypothesis for why Medicare has failed to gain acceptance of health plans in the US.
PMID : 12475125 [PubMed - Indexed for MEDLINE]
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Full Author Information
| First Name | LastName | Initials |
| Jacob | Glazer | J |
| Thomas G | McGuire | TG |
Affiliation: Tel Aviv University, Israel.
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MESH categories and related page links
This article was linked to the MESH categories shown on the left below. The links on the right are related Memletics pages.
Category links from this article:- Consumer Satisfaction - statistics & numerical data
- Contract Services - economics, standards
- Decision Making
- Fees and Charges
- Health Benefit Plans, Employee - economics, organization & administration
- Health Care Rationing
- Health Services Research
- Humans
- Income - statistics & numerical data
- Managed Care Programs - economics, standards
- Medicare - economics, organization & administration
- Models, Econometric
- Private Sector
- Public Sector
- Quality of Health Care
- United States
| | Related Memletics topics: |
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