Overcoming resistance against managed care: insights from a bargaining model
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In: Health Economics Review, Vol. 7, No. 1, 19, 22.05.2017.
Research output: Journal contributions › Journal articles › Research › peer-review
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TY - JOUR
T1 - Overcoming resistance against managed care
T2 - insights from a bargaining model
AU - Ehlert, Andree
AU - Wein, Thomas
AU - Zweifel, Peter
PY - 2017/5/22
Y1 - 2017/5/22
N2 - 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.
AB - 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.
KW - Health sciences
KW - Consumer choice
KW - Game theory
KW - Germany
KW - Health insurance
KW - Healthcare reform
KW - Managed care
KW - Multilateral Nash bargaining
KW - Switzerland
KW - The Netherlands
UR - http://www.scopus.com/inward/record.url?scp=85019643230&partnerID=8YFLogxK
UR - https://www.mendeley.com/catalogue/f1696c2b-aba2-3eea-9773-7523092b5d82/
U2 - 10.1186/s13561-017-0156-4
DO - 10.1186/s13561-017-0156-4
M3 - Journal articles
C2 - 28534279
AN - SCOPUS:85019643230
VL - 7
JO - Health Economics Review
JF - Health Economics Review
SN - 2191-1991
IS - 1
M1 - 19
ER -