Insurer-provider networks in the medical care market:
"Managed care health insurers in the US restrict their enrollees' choice of hospitals to specific networks. This paper investigates the causes and welfare effects of the observed hospital networks. A simple profit maximization model explains roughly 63 per cent of the observed contracts be...
Gespeichert in:
| 1. Verfasser: | |
|---|---|
| Format: | Buch |
| Sprache: | English |
| Veröffentlicht: |
Cambridge, Mass.
National Bureau of Economic Research
2005
|
| Schriftenreihe: | National Bureau of Economic Research <Cambridge, Mass.>: NBER working paper series
11822 |
| Schlagworte: | |
| Online-Zugang: | kostenfrei |
| Zusammenfassung: | "Managed care health insurers in the US restrict their enrollees' choice of hospitals to specific networks. This paper investigates the causes and welfare effects of the observed hospital networks. A simple profit maximization model explains roughly 63 per cent of the observed contracts between insurers and hospitals. I estimate a model that includes an additional effect: hospitals that do not need to contract with all insurance plans to secure demand (for example, providers that are capacity constrained under a limited or selective network) may demand high prices that not all insurers are willing to pay. Hospitals can merge to form "systems" which may also affect bargaining between hospitals and insurance plans. The analysis estimates the expected division of profits between insurance plans and different types of hospitals using data on insurers' choices of network. Hospitals in systems are found to capture markups of approximately 19 per cent of revenues, in contrast to non-system, non-capacity constrained providers, whose markups are assumed to be about zero. System members also impose high penalties on plans that exclude their partners. Providers that are expected to be capacity constrained capture markups of about 14 per cent of revenues. I show that these high markups imply an incentive for hospitals to under-invest in capacity despite a median benefit to consumers of over |
| Beschreibung: | 54 S. graph. Darst. |
Internformat
MARC
| LEADER | 00000nam a2200000zcb4500 | ||
|---|---|---|---|
| 001 | BV023591818 | ||
| 003 | DE-604 | ||
| 005 | 20090619 | ||
| 007 | t | ||
| 008 | 060328s2005 xxud||| |||| 00||| eng d | ||
| 035 | |a (OCoLC)62768366 | ||
| 035 | |a (DE-599)BVBBV023591818 | ||
| 040 | |a DE-604 |b ger | ||
| 041 | 0 | |a eng | |
| 044 | |a xxu |c XD-US | ||
| 049 | |a DE-521 |a DE-19 | ||
| 050 | 0 | |a HB1 | |
| 100 | 1 | |a Ho, Katherine |e Verfasser |0 (DE-588)131561839 |4 aut | |
| 245 | 1 | 0 | |a Insurer-provider networks in the medical care market |c Katherine Ho |
| 264 | 1 | |a Cambridge, Mass. |b National Bureau of Economic Research |c 2005 | |
| 300 | |a 54 S. |b graph. Darst. | ||
| 336 | |b txt |2 rdacontent | ||
| 337 | |b n |2 rdamedia | ||
| 338 | |b nc |2 rdacarrier | ||
| 490 | 1 | |a National Bureau of Economic Research <Cambridge, Mass.>: NBER working paper series |v 11822 | |
| 520 | 3 | |a "Managed care health insurers in the US restrict their enrollees' choice of hospitals to specific networks. This paper investigates the causes and welfare effects of the observed hospital networks. A simple profit maximization model explains roughly 63 per cent of the observed contracts between insurers and hospitals. I estimate a model that includes an additional effect: hospitals that do not need to contract with all insurance plans to secure demand (for example, providers that are capacity constrained under a limited or selective network) may demand high prices that not all insurers are willing to pay. Hospitals can merge to form "systems" which may also affect bargaining between hospitals and insurance plans. The analysis estimates the expected division of profits between insurance plans and different types of hospitals using data on insurers' choices of network. Hospitals in systems are found to capture markups of approximately 19 per cent of revenues, in contrast to non-system, non-capacity constrained providers, whose markups are assumed to be about zero. System members also impose high penalties on plans that exclude their partners. Providers that are expected to be capacity constrained capture markups of about 14 per cent of revenues. I show that these high markups imply an incentive for hospitals to under-invest in capacity despite a median benefit to consumers of over | |
| 650 | 4 | |a Economics, Hospital |z United States | |
| 650 | 4 | |a Health insurance |z United States | |
| 650 | 4 | |a Insurance, Hospitalization |x economics |z United States | |
| 650 | 4 | |a Managed Care Programs |x economics |z United States | |
| 650 | 4 | |a Marketing of Health Services |x economics |z United States | |
| 650 | 4 | |a Medical care |z United States | |
| 650 | 4 | |a Models, Economic |z United States | |
| 650 | 4 | |a Provider-sponsored organizations (Medical care) |z United States | |
| 651 | 4 | |a USA | |
| 776 | 0 | 8 | |i Erscheint auch als |n Online-Ausgabe |
| 830 | 0 | |a National Bureau of Economic Research <Cambridge, Mass.>: NBER working paper series |v 11822 |w (DE-604)BV002801238 |9 11822 | |
| 856 | 4 | 1 | |u http://papers.nber.org/papers/w11822.pdf |z kostenfrei |3 Volltext |
| 999 | |a oai:aleph.bib-bvb.de:BVB01-016907148 | ||
Datensatz im Suchindex
| _version_ | 1804138249616097280 |
|---|---|
| adam_txt | |
| any_adam_object | |
| any_adam_object_boolean | |
| author | Ho, Katherine |
| author_GND | (DE-588)131561839 |
| author_facet | Ho, Katherine |
| author_role | aut |
| author_sort | Ho, Katherine |
| author_variant | k h kh |
| building | Verbundindex |
| bvnumber | BV023591818 |
| callnumber-first | H - Social Science |
| callnumber-label | HB1 |
| callnumber-raw | HB1 |
| callnumber-search | HB1 |
| callnumber-sort | HB 11 |
| callnumber-subject | HB - Economic Theory and Demography |
| ctrlnum | (OCoLC)62768366 (DE-599)BVBBV023591818 |
| format | Book |
| fullrecord | <?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>03049nam a2200433zcb4500</leader><controlfield tag="001">BV023591818</controlfield><controlfield tag="003">DE-604</controlfield><controlfield tag="005">20090619 </controlfield><controlfield tag="007">t</controlfield><controlfield tag="008">060328s2005 xxud||| |||| 00||| eng d</controlfield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(OCoLC)62768366</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-599)BVBBV023591818</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-604</subfield><subfield code="b">ger</subfield></datafield><datafield tag="041" ind1="0" ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="044" ind1=" " ind2=" "><subfield code="a">xxu</subfield><subfield code="c">XD-US</subfield></datafield><datafield tag="049" ind1=" " ind2=" "><subfield code="a">DE-521</subfield><subfield code="a">DE-19</subfield></datafield><datafield tag="050" ind1=" " ind2="0"><subfield code="a">HB1</subfield></datafield><datafield tag="100" ind1="1" ind2=" "><subfield code="a">Ho, Katherine</subfield><subfield code="e">Verfasser</subfield><subfield code="0">(DE-588)131561839</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Insurer-provider networks in the medical care market</subfield><subfield code="c">Katherine Ho</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="a">Cambridge, Mass.</subfield><subfield code="b">National Bureau of Economic Research</subfield><subfield code="c">2005</subfield></datafield><datafield tag="300" ind1=" " ind2=" "><subfield code="a">54 S.</subfield><subfield code="b">graph. Darst.</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="b">n</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="b">nc</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="490" ind1="1" ind2=" "><subfield code="a">National Bureau of Economic Research <Cambridge, Mass.>: NBER working paper series</subfield><subfield code="v">11822</subfield></datafield><datafield tag="520" ind1="3" ind2=" "><subfield code="a">"Managed care health insurers in the US restrict their enrollees' choice of hospitals to specific networks. This paper investigates the causes and welfare effects of the observed hospital networks. A simple profit maximization model explains roughly 63 per cent of the observed contracts between insurers and hospitals. I estimate a model that includes an additional effect: hospitals that do not need to contract with all insurance plans to secure demand (for example, providers that are capacity constrained under a limited or selective network) may demand high prices that not all insurers are willing to pay. Hospitals can merge to form "systems" which may also affect bargaining between hospitals and insurance plans. The analysis estimates the expected division of profits between insurance plans and different types of hospitals using data on insurers' choices of network. Hospitals in systems are found to capture markups of approximately 19 per cent of revenues, in contrast to non-system, non-capacity constrained providers, whose markups are assumed to be about zero. System members also impose high penalties on plans that exclude their partners. Providers that are expected to be capacity constrained capture markups of about 14 per cent of revenues. I show that these high markups imply an incentive for hospitals to under-invest in capacity despite a median benefit to consumers of over</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Economics, Hospital</subfield><subfield code="z">United States</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Health insurance</subfield><subfield code="z">United States</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Insurance, Hospitalization</subfield><subfield code="x">economics</subfield><subfield code="z">United States</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Managed Care Programs</subfield><subfield code="x">economics</subfield><subfield code="z">United States</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Marketing of Health Services</subfield><subfield code="x">economics</subfield><subfield code="z">United States</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Medical care</subfield><subfield code="z">United States</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Models, Economic</subfield><subfield code="z">United States</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Provider-sponsored organizations (Medical care)</subfield><subfield code="z">United States</subfield></datafield><datafield tag="651" ind1=" " ind2="4"><subfield code="a">USA</subfield></datafield><datafield tag="776" ind1="0" ind2="8"><subfield code="i">Erscheint auch als</subfield><subfield code="n">Online-Ausgabe</subfield></datafield><datafield tag="830" ind1=" " ind2="0"><subfield code="a">National Bureau of Economic Research <Cambridge, Mass.>: NBER working paper series</subfield><subfield code="v">11822</subfield><subfield code="w">(DE-604)BV002801238</subfield><subfield code="9">11822</subfield></datafield><datafield tag="856" ind1="4" ind2="1"><subfield code="u">http://papers.nber.org/papers/w11822.pdf</subfield><subfield code="z">kostenfrei</subfield><subfield code="3">Volltext</subfield></datafield><datafield tag="999" ind1=" " ind2=" "><subfield code="a">oai:aleph.bib-bvb.de:BVB01-016907148</subfield></datafield></record></collection> |
| geographic | USA |
| geographic_facet | USA |
| id | DE-604.BV023591818 |
| illustrated | Illustrated |
| index_date | 2024-07-02T22:41:29Z |
| indexdate | 2024-07-09T21:25:11Z |
| institution | BVB |
| language | English |
| oai_aleph_id | oai:aleph.bib-bvb.de:BVB01-016907148 |
| oclc_num | 62768366 |
| open_access_boolean | 1 |
| owner | DE-521 DE-19 DE-BY-UBM |
| owner_facet | DE-521 DE-19 DE-BY-UBM |
| physical | 54 S. graph. Darst. |
| publishDate | 2005 |
| publishDateSearch | 2005 |
| publishDateSort | 2005 |
| publisher | National Bureau of Economic Research |
| record_format | marc |
| series | National Bureau of Economic Research <Cambridge, Mass.>: NBER working paper series |
| series2 | National Bureau of Economic Research <Cambridge, Mass.>: NBER working paper series |
| spelling | Ho, Katherine Verfasser (DE-588)131561839 aut Insurer-provider networks in the medical care market Katherine Ho Cambridge, Mass. National Bureau of Economic Research 2005 54 S. graph. Darst. txt rdacontent n rdamedia nc rdacarrier National Bureau of Economic Research <Cambridge, Mass.>: NBER working paper series 11822 "Managed care health insurers in the US restrict their enrollees' choice of hospitals to specific networks. This paper investigates the causes and welfare effects of the observed hospital networks. A simple profit maximization model explains roughly 63 per cent of the observed contracts between insurers and hospitals. I estimate a model that includes an additional effect: hospitals that do not need to contract with all insurance plans to secure demand (for example, providers that are capacity constrained under a limited or selective network) may demand high prices that not all insurers are willing to pay. Hospitals can merge to form "systems" which may also affect bargaining between hospitals and insurance plans. The analysis estimates the expected division of profits between insurance plans and different types of hospitals using data on insurers' choices of network. Hospitals in systems are found to capture markups of approximately 19 per cent of revenues, in contrast to non-system, non-capacity constrained providers, whose markups are assumed to be about zero. System members also impose high penalties on plans that exclude their partners. Providers that are expected to be capacity constrained capture markups of about 14 per cent of revenues. I show that these high markups imply an incentive for hospitals to under-invest in capacity despite a median benefit to consumers of over Economics, Hospital United States Health insurance United States Insurance, Hospitalization economics United States Managed Care Programs economics United States Marketing of Health Services economics United States Medical care United States Models, Economic United States Provider-sponsored organizations (Medical care) United States USA Erscheint auch als Online-Ausgabe National Bureau of Economic Research <Cambridge, Mass.>: NBER working paper series 11822 (DE-604)BV002801238 11822 http://papers.nber.org/papers/w11822.pdf kostenfrei Volltext |
| spellingShingle | Ho, Katherine Insurer-provider networks in the medical care market National Bureau of Economic Research <Cambridge, Mass.>: NBER working paper series Economics, Hospital United States Health insurance United States Insurance, Hospitalization economics United States Managed Care Programs economics United States Marketing of Health Services economics United States Medical care United States Models, Economic United States Provider-sponsored organizations (Medical care) United States |
| title | Insurer-provider networks in the medical care market |
| title_auth | Insurer-provider networks in the medical care market |
| title_exact_search | Insurer-provider networks in the medical care market |
| title_exact_search_txtP | Insurer-provider networks in the medical care market |
| title_full | Insurer-provider networks in the medical care market Katherine Ho |
| title_fullStr | Insurer-provider networks in the medical care market Katherine Ho |
| title_full_unstemmed | Insurer-provider networks in the medical care market Katherine Ho |
| title_short | Insurer-provider networks in the medical care market |
| title_sort | insurer provider networks in the medical care market |
| topic | Economics, Hospital United States Health insurance United States Insurance, Hospitalization economics United States Managed Care Programs economics United States Marketing of Health Services economics United States Medical care United States Models, Economic United States Provider-sponsored organizations (Medical care) United States |
| topic_facet | Economics, Hospital United States Health insurance United States Insurance, Hospitalization economics United States Managed Care Programs economics United States Marketing of Health Services economics United States Medical care United States Models, Economic United States Provider-sponsored organizations (Medical care) United States USA |
| url | http://papers.nber.org/papers/w11822.pdf |
| volume_link | (DE-604)BV002801238 |
| work_keys_str_mv | AT hokatherine insurerprovidernetworksinthemedicalcaremarket |