Regulating Health Care Markets
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Risk Adjustment Risk Sharing And Premium Regulation In Health Insurance Markets
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Author : Thomas G. McGuire
language : en
Publisher: Academic Press
Release Date : 2018-08-06
Risk Adjustment Risk Sharing And Premium Regulation In Health Insurance Markets written by Thomas G. McGuire and has been published by Academic Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2018-08-06 with Business & Economics categories.
Risk Adjustment, Risk Sharing and Premium Regulation in Health Insurance Markets: Theory and Practice describes the goals, design and evaluation of health plan payment systems. Part I contains 5 chapters discussing the role of health plan payment in regulated health insurance markets, key aspects of payment design (i.e. risk adjustment, risk sharing and premium regulation), and evaluation methods using administrative data on medical spending. Part II contains 14 chapters describing the health plan payment system in 14 countries and sectors around the world, including Australia, Belgium, Chile, China, Columbia, Germany, Ireland, Israel, the Netherlands, Russia, Switzerland and the United States. Authors discuss the evolution of these payment schemes, along with ongoing reforms and key lessons on the design of health plan payment. Provides a conceptual toolkit that describes the goals, design and evaluation of health plan payment systems in the context of policy paradigms, such as efficiency, affordability, fairness and avoidance of risk selection Brings together international experience from many different countries that apply regulated competition in different ways Delivers a practical toolkit for the evaluation of health plan payment modalities from the standpoint of efficiency and fairness
The Economics Of Us Healthcare Competition Innovation Regulation And Organizations
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Author :
language : en
Publisher: Stigler Center
Release Date : 2023-05-01
The Economics Of Us Healthcare Competition Innovation Regulation And Organizations written by and has been published by Stigler Center this book supported file pdf, txt, epub, kindle and other format this book has been release on 2023-05-01 with Business & Economics categories.
This eBook was born out of a general diagnosis that the US healthcare sector is not only one of the most studied industries in economics but also one of the areas where the field can make the most progress. Indeed, the American healthcare industry has many features that are particularly attractive to economists. It is one of (if not the) largest sectors of the US economy, accounting for almost 20% of the national Gross Domestic Product and employing tens of millions of workers. Firms range from large conglomerates to small providers, and there is strong government-private sector interaction, with federal, state, and local governments shaping policy. The industry also has many failures, is undergoing tremendous change, and produces a wealth of data (even if not always perfectly formatted). The field, however, is far from saturated. Healthcare is such a complex and intricate sector, one where details matter so much that it is almost its own subfield of economics. These high barriers to entry prevent scholars from researching healthcare topics and weaken the cross-pollination of ideas, an increasing hallmark of many other areas. This is problematic, not the least, because any major advances in healthcare economics literally save lives (and billions of dollars). This project aimed to help lower these barriers and kick-start broader collaborations.
Regulating Health Care Markets
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Author : Parker Rogers
language : en
Publisher:
Release Date : 2023
Regulating Health Care Markets written by Parker Rogers and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2023 with categories.
Chapter One examines how FDA regulation affects innovation and market concentration. I examine this question by exploiting FDA deregulation events that affected certain medical device types but not others. I collect comprehensive data on medical device innovation, device safety, firm entry, prices, and regulatory changes and enhance these data using text analysis methods. My analysis of these data reveals three key findings. First, deregulation events significantly increased the quantity and quality of new technologies in affected medical device types relative to controls. These increases are particularly strong among small and inexperienced firms. Second, these events increased firm entry and reduced prices for medical procedures that utilize affected medical device types. Finally, rates of serious injuries and deaths attributable to defective devices did not significantly increase following these events. Interestingly, deregulating certain device types was associated with reduced adverse event rates, possibly due to firms increasing their emphasis on product safety in response to increased litigation risk. In Chapter Two, we analyze wartime prosthetic device patents to investigate how demand shocks and procurement environments can shape medical innovation. We use machine learning tools to develop new data describing the aspects of medical and mechanical innovations that are emphasized in patent documents. Our analysis of historical patents yields three primary facts. First, we find that the U.S. Civil War and World War I led to substantial increases in the quantity of prosthetic device patenting relative to patenting in other medical and mechanical technology classes. Second, we find that the Civil War led inventors to increase their focus on reducing cost, while World War I did not. The Civil War era emphasis on cost is consistent with a role for that period's cost-conscious procurement model. Third, we find that inventors emphasized dimensions of product quality (e.g., a prosthetic limb's comfort or facilitation of employment) that aligned with differences in buyers' preferences across wars. We conclude that procurement environments can significantly shape the dimensions of the technical frontier with which inventors engage. In Chapter Three, we study how government price reforms affect innovation, market structure, and product quality within the health care sector. We exploit a Medicare payment reform that reduced expenditures on certain types of durable medical equipment (DME) by 66% while leaving other types unaffected. We find that manufacturers filed 29% fewer patents and introduced 22% fewer new models in DME types affected by the price reform relative to those that were unaffected. Additionally, patents filed after the price reform increasingly focused on "process" rather than "product" innovation, consistent with increased market demand for lower-cost products. The market structure was also affected, with 25% fewer manufacturers entering affected product markets and a 65% increase in outsourcing to foreign companies. The shift towards cost-cutting, both in patenting and supply chain restructuring, was associated with increased device repair rates among Medicare beneficiaries and reported adverse events. Firms that outsourced to foreign manufacturers experienced the highest increase in adverse events. While the Medicare price reform generated substantial savings, these gains were dampened by the adverse effects on innovation, market structure, and product quality in the long run. Our findings highlight the importance of considering long-run impacts when designing policy reforms.
State Policy Options
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Author : Jack Needleman
language : en
Publisher:
Release Date : 1982
State Policy Options written by Jack Needleman and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1982 with Health planning categories.
Governing The Healthcare Market
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Author : Hongwen Zhao
language : en
Publisher:
Release Date : 2005
Governing The Healthcare Market written by Hongwen Zhao and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2005 with Health care reform categories.
Without an effective state health financing tool, nor mature market institutions, China is not able to use neither performance-based regulation nor technology-based regulation. China has adopted a management-based regulatory strategy but the absence of effective governance structure hinders effective regulation. If the reform objectives of improving healthcare quality while costs are to be attained, China will need to develop purchasing tools to alter the current perverse incentives for provider behavior. Government will also need to work with civil society organizations to develop tools for clinical governance, such as clinical audit for risk management and hospital accreditation programs. To do so requires establishing arms-length governance mechanisms between health departments and hospitals, and appropriate corporate governance structures within hospitals. Specifically, MOH needs to establish a technical policy think tank to investigate all the policy issues arising from the announcement of the 1997 health reform, including coordination with other line ministries and provincial authorities, and formulation and implementation of a policy research agenda, in order to attain a market-based governance system for health by 2010.
State Policy Options
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Author : Jack Needleman
language : en
Publisher:
Release Date : 1982
State Policy Options written by Jack Needleman and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1982 with categories.
State Policy Options
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Author : Karen W. Tyson
language : en
Publisher:
Release Date : 1982
State Policy Options written by Karen W. Tyson and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1982 with Competition categories.
Strategic Interactions In Regulated Markets
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Author : Martin Lábaj
language : en
Publisher:
Release Date : 2023
Strategic Interactions In Regulated Markets written by Martin Lábaj and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2023 with categories.
Usually, health policy makers face a trade-off between benefits and costs from healthcare markets regulation and deregulation. We argue that these markets and policy reforms should not be studied in isolation as the effects from regulation in one market spillover to other markets. In particular, we study entry decisions and strategic interactions between general practitioners, pediatricians, and pharmacies. We show that a better regulation and accessibility of one profession allow policy makers to relax spatial restrictions and regulations of other healthcare professionals. We document that these spillover effects could be sizeable as the entry thresholds for pharmacies to enter the market decrease by 70 % with the presence of a general practitioner. Our counterfactual analysis suggests that a better coverage of GPs would improve spatial accessibility of pharmaceutical services and lead to an entry of new pharmacies in currently unattractive markets, mostly in rural areas.
Health Care Policy And Regulation
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Author : Thomas A. Abbott III
language : en
Publisher: Springer Science & Business Media
Release Date : 2012-12-06
Health Care Policy And Regulation written by Thomas A. Abbott III and has been published by Springer Science & Business Media this book supported file pdf, txt, epub, kindle and other format this book has been release on 2012-12-06 with Business & Economics categories.
5 care reforms. Part II: Price Regulation The second partofthis volume examines the role ofprice regulation in controlling health care costs. It contains three chapters. In chapter seven, I examine the alternatives for regulating pharmaceutical prices. In chapter eight, Jack Hadley examines the impactofvarious forms ofhospital price regulation; while in chapter nine,MarkPaulyexaminestheroleofpriceregulation incontrollingphysician fees. Chapter seven focuses on the issue of regulating pharmaceutical prices. There are two key issues examined in this paper. First, is there a clear need for price regulation, and second, can price regulation work in this industry? In response to the first question, I come to the conclusion that the proponents ofprice regulation have not really proven their case. Although the financial returns in the pharmaceu tical industry have been slightly higher than expected during the 1970s and 1980s, there is not overwhelming evidence of"price gouging" or excessive profits on the part of the industry. In response to the second question, the answer is clearly no. The traditional approaches to price regulation will not have the intended affect of eliminating excess profits from the industry while maintaining the incentives for research and development. First, rate-of-return regulation, the most natural approach, would result in many adverse incentives-includingexcessive investment in research and developmentinorderto inflatetheratebaseused tocalculatedtheallowablereturns.
Regulating Managed Care
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Author : Stuart H. Altman
language : en
Publisher: Jossey-Bass
Release Date : 1999-06-25
Regulating Managed Care written by Stuart H. Altman and has been published by Jossey-Bass this book supported file pdf, txt, epub, kindle and other format this book has been release on 1999-06-25 with Health & Fitness categories.
What should be government's role in a market-oriented health caresystem? What's the appropriate amount of regulation? Who should regulate-states, federal government, or marketforces? What role do the courts play in this regulation? Are there existing models that might guide leaders in designing aneffective regulatory structure? Welcome to the great managed care debate. In Regulating ManagedCare, twenty-six of the nation's leading health policy experts givehealth care administrators, clinicians, and policy makers insightinto the issues behind this critical exchange and provide leaderswith a road map to assess the policy options available to protectthe quality of our health care delivery system. "This collection of papers, from an extraordinary group of authors,makes a valuable contribution to the ongoing policy debate and willbe of interest to anyone concerned with the future of our healthcare system."---Charles A. Sanders, retired chairman and CEO GlaxoInc. and former general director, Massachusetts General Hospital