Insurer-provider networks in the medical care market

Insurer-provider networks in the medical care ...
Katherine Ho, Katherine Ho
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Last edited by MARC Bot
December 13, 2020 | History

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 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 $330,000 per new bed per year"--National Bureau of Economic Research web site.

Publish Date
Language
English

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Edition Availability
Cover of: Insurer-provider networks in the medical care market
Insurer-provider networks in the medical care market
2005, National Bureau of Economic Research
Electronic resource in English
Cover of: Insurer-provider networks in the medical care market
Insurer-provider networks in the medical care market
2005, National Bureau of Economic Research
in English

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Book Details


Edition Notes

Includes bibliographical references.
Title from PDF file as viewed on 12/19/2005.
Also available in print.
System requirements: Adobe Acrobat Reader.
Mode of access: World Wide Web.

Published in
Cambridge, MA
Series
NBER working paper series ;, working paper 11822, Working paper series (National Bureau of Economic Research : Online) ;, working paper no. 11822.

Classifications

Library of Congress
HB1

The Physical Object

Format
Electronic resource

ID Numbers

Open Library
OL3479578M
LCCN
2005705272

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December 13, 2020 Edited by MARC Bot import existing book
November 28, 2012 Edited by AnandBot Fixed spam edits.
November 23, 2012 Edited by 62.109.0.70 Edited without comment.
December 3, 2010 Edited by Open Library Bot Added subjects from MARC records.
December 10, 2009 Created by WorkBot add works page