Hospital Choices, Hospital Prices, and Financial Incentives to Physicians
研究了加州私人保险分娩中,保险公司如何根据医院价格、距离和质量来推荐医院,发现按人头付费的医生越多,保险公司对价格越敏感,会引导患者去价格更低但质量相似的医院。
We estimate an insurer-specific preference function which rationalizes hospital referrals for privately insured births in California. The function is additively separable in: a hospital price paid by the insurer, the distance traveled, and plan- and severity-specific hospital fixed effects (capturing hospital quality). We use an inequality estimator that allows for errors in price and detailed hospital-severity interactions and obtain markedly different results than those from a logit. The estimates indicate that insurers with more capitated physicians are more responsive to price. Capitated plans send patients further to utilize similar quality, lower-priced hospitals; but the cost-quality trade-off does not vary with capitation rates.