医疗保险市场中保险公司与医疗服务提供者的网络关系

Insurer-Provider Networks in the Medical Care Market

American Economic Review · 2009
被引 295
人大 A+FT50ABS 4*

中文导读

利用管理式医疗保险公司提供的医院网络数据,估计保险公司与医院之间的利润分配,发现对消费者吸引力强或受产能约束的医院以及合并后的医院能获得更高利润。

Abstract

I use data on the hospital networks offered by managed care health insurers to estimate the expected division of profits between insurers and providers. I include a simple profit-maximization framework and an additional effect: hospitals that can secure demand without contracting with all insurers (e.g., those most attractive to consumers and those that are capacity constrained) may demand high prices that some insurers refuse to pay. Hospital mergers may also affect price bargaining. I estimate that all three types of hospitals capture higher markups than other providers. These results provide information on the hospital investment incentives generated by bargaining.

管理式医疗医院网络利润分配议价能力