Optimal payment systems for health services
Journal of Health EconomicsPublished 1 January 1990
Randall P. Ellis, Thomas G. McGuire
Citations323
SJR quartileQ1
SJR score2.43
SNIP1.65
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TL;DR
This work describes the optimal combination of insurance and reimbursement systems that maximize consumer welfare and uses a model of conflict resolution based on bargaining theory to represent the outcome when the payment system creates divergences between desired demand and desired supply.
Abstract
Demand-side cost sharing and the supply-side reimbursement system provide two separate instruments that can be used to influence the quantity of health services consumed. For risk-averse consumers, optimal payment systems--pairs of insurance and reimbursement plans--are characterized by conflict rather than consensus between patient and provider about the quantity of treatment. A model of conflict resolution based on bargaining theory is used to represent the outcome when the payment system creates divergences between desired demand and desired supply. Using that model, we describe the optimal combination of insurance and reimbursement systems that maximize consumer welfare.
Keywords
Economics, Econometrics and Finance
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