Reading list and lectures
1. Aims, types of payment systems and characteristics of the health care market
Aims: Efficiency (dynamic, static), equity, cost-control, predictability (for both parties, to enable planning), robustness (minimize consequences of error if mistakes are made), minimize process cost
Types: Prospective, retrospective, per capita vs. fee-for service vs. pay for performance. Mix
Special characteristics of the health market: Asymmetric information, uncertainty, non-repeated business
Two payment decision levels:
- Mainly private vs. public
- Type of regulation within each system
Reading:
Zweifel, P., Breyer, F., & Kifmann, M. (2009). Health economics. Springer. Chapter 10 (payment Systems)
Ellis, R. P., & McGuire, T. G. (1990). Optimal payment systems for health services. Journal of health economics, 9(4), 375-396.
Chalkley, M., & Malcomson, J. M. (2000). Government purchasing of health services. Handbook of health economics, 1, 847-890.
2. Paying hospitals: Unintended and distortionary effects of payment systems in multitasking organizations
Reading:
Eggleston, K. (2005). Multitasking and mixed systems for provider payment. Journal of Health Economics, 24(1), 211-223.
Sloan, F. A. (2000). Not-for-profit ownership and hospital behavior. Handbook of health economics, 1, 1141-1174.
Kaarboe, O., & Siciliani, L. (2011). Multi‐tasking, quality and pay for performance. Health economics, 20(2), 225-238.
3. Paying physicians: Fee-for-Service or Pay for performance?
- Advantages and disadvantages of _Retrospective reimbursement, fee-for-service, pay for performance
(Cream skimming, dumping, supplier induced demand etc)
Importance of intrinsic motivation
Distortionary effects of incentives
Reading
McGuire, T. G. (2000). Physician agency. Handbook of health economics, 1, 461-536.
McGuire (2011) Physician Agency and Payment for Primary Medical Care The Oxford Handbook of Health Economics
Godager, G., Iversen, T., & Ma, C. A. (2009). Service motives and profit incentives among physicians. International journal of health care finance and economics, 9(1), 39-57.
4. Paying for pharmaceuticals: Statically vs. Dynamically efficient payment systems
The conflict between static efficiency (marginal cost = price = 0) and dynamic efficiency (require price > 0!)
Different types of price regulation (reference pricing, trinnprissystemet, value basd prixing, prize competitions)
Reading:
Morton, F. S., & Kyle, M. (2012). Markets for pharmaceutical products. (M. Pauly, T. Mcguire, & P. Barros)Handbook of Health Economics, 765-772.
Brekke, K. R., Holmas, T. H., & Straume, O. R. (2011). Reference pricing, competition, and pharmaceutical expenditures: Theory and evidence from a natural experiment. Journal of Public Economics, 95(7), 624-638.
5. Paying for long term care: Why is there so little private long term care insurance?
Reading:
Norton, E. C. (2000). Long-term care. Handbook of health economics, 1, 955-994.Yang, Z., Norton, E. C., &
Brown, J. R., & Finkelstein, A. (2007). Why is the market for long-term care insurance so small?. Journal of Public Economics, 91(10), 1967-1991.
Lakdawalla, D. N., & Philipson, T. (2002). The rise in old-age longevity and the market for long-term care. The American Economic Review, 92(1), 295-306.
6. Incentives in organizations
Reading:
Gibbons, Robert (1998). “Incentives in Organizations.” Journal of Economic Perspectives 12: 115-32.
Chandra, A., Cutler, D., & Song, Z. (2012). Who ordered that? The economics of treatment choices in medical care. Handbook of health economics, 2, 397-432.