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Managed Care and Physician Incentives: The Effects of Competition on the Cost and Quality of Care

Author

Listed:
  • Cooper David J.

    (Case Western Reserve University, djc13@po.cwru.edu)

  • Rebitzer James B

    (Case Western Reserve University, jim.rebitzer@gmail.com)

Abstract

We analyze the effect that competition between HMOs has on the cost and quality of medical services. Our key result is that increasing competition enhances consumer utility while also moderating the impact of managed care on quality and costs. Indeed, we find that heightened competition between HMOs can cause an overall increase in care quality and costs. This result derives from an important, but overlooked, feature of the managed care market place. Plans differentiate themselves by the size and depth of their provider network. The resulting competition to attract physicians exerts a moderating effect on the incentive contracts HMOs write with providers.

Suggested Citation

  • Cooper David J. & Rebitzer James B, 2006. "Managed Care and Physician Incentives: The Effects of Competition on the Cost and Quality of Care," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 5(1), pages 1-32, July.
    • Handle: RePEc:bpj:bejeap:v:contributions.5:y:2006:i:1:n:16
    DOI: 10.1515/1538-0645.1409
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    Citations

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    Cited by:

    1. James B. Rebitzer & Mark E. Votruba, 2011. "Organizational Economics and Physician Practices," NBER Working Papers 17535, National Bureau of Economic Research, Inc.
    2. Howell, Bronwyn, 2007. "Financial Risk in Primary Health Care Contracting: Implications for Sector Structure, Ownership and Outcomes," Working Paper Series 19063, Victoria University of Wellington, The New Zealand Institute for the Study of Competition and Regulation.
    3. Randall D. Cebul & James B. Rebitzer & Lowell J. Taylor & Mark E. Votruba, 2008. "Organizational Fragmentation and Care Quality in the U.S. Healthcare System," Journal of Economic Perspectives, American Economic Association, vol. 22(4), pages 93-113, Fall.
    4. repec:vuw:vuwscr:19063 is not listed on IDEAS
    5. Rebitzer, James B. & Taylor, Lowell J., 2011. "Extrinsic Rewards and Intrinsic Motives: Standard and Behavioral Approaches to Agency and Labor Markets," Handbook of Labor Economics, in: O. Ashenfelter & D. Card (ed.), Handbook of Labor Economics, edition 1, volume 4, chapter 8, pages 701-772, Elsevier.
    6. Howell, Bronwyn, 2007. "Financial Risk in Primary Health Care Contracting: Implications for Sector Structure, Ownership and Outcomes," Working Paper Series 3964, Victoria University of Wellington, The New Zealand Institute for the Study of Competition and Regulation.

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