International Journal of Health Care Finance and Economics This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

The effect of physician remuneration on regional variation in hospital treatments
Abstract We study medical practice variations for nine hospital treatments in the Netherlands. Our panel data estimations include various control factors and physician’s role to explain hospital treatments in about 3,000 Dutch zip code regions over the period 2006–2009. In particular, we exploit the physicians’ remuneration difference—fee-for-service (FFS) versus salary—to explain the effect of financial incentives on medical production. We find that utilization rates are higher in geographical areas where more patients are treated by physicians that are paid FFS. This effect is strong for suppl...
Source: International Journal of Health Care Finance and Economics - February 1, 2015 Category: Health Management Source Type: research

Reference pricing in the presence of pseudo-generics
Abstract This paper looks at producers of branded and generic pharmaceuticals’ pricing decisions under two possible reimbursement schemes—reference pricing and fixed percentage reimbursement—and under two settings—one where the branded producer only sells the (off-patent) branded pharmaceutical and another where, in addition, it may also sell its own generic version, a so called pseudo-generic. We find different pricing responses from firms under the two reimbursement schemes and across the two settings analysed (with or without a pseudo-generic), and show that pseudo-generics may have an anticomp...
Source: International Journal of Health Care Finance and Economics - February 1, 2015 Category: Health Management Source Type: research

Can universal access and competition in long-term care insurance be combined?
Abstract In countries with a public long-term care (LTC) insurance scheme administered by multiple non-competing insurers, these insurers typically lack incentives for purchasing cost-effective LTC because they are not at risk for LTC expenses. Plans to introduce these incentives by allowing competition among risk bearing LTC insurers are likely to jeopardize universal access. Combining universal access and competition among risk bearing LTC-insurers requires an adequate system of risk adjustment. While risk adjustment is now widely adopted in health insurance, LTC-specific features cause uncertainty abou...
Source: International Journal of Health Care Finance and Economics - January 30, 2015 Category: Health Management Source Type: research

Market power and provider consolidation in physician markets
In this study we make use of a private health insurance claims data set to analyze physician market power for two specialties within three mid-sized US metropolitan areas. Using a method developed for hospital competition analysis, we estimate measures of consumer willingness-to-pay for physician practices within each of these markets and relate these to the prices paid to these practices for a set of physician services. Our results are suggestive of the presence of market power in the markets that we analyze. We simulate physician practice mergers for the two largest practices in each market for each specialty analyzed. R...
Source: International Journal of Health Care Finance and Economics - January 23, 2015 Category: Health Management Source Type: research

Unmet needs in formal care: kindling the spark for caregiving behavior
Abstract This paper studies if a situation of formal care unmet needs is a strong motivation for the onset of caregiving behavior, and if becoming caregiving is a compelling argument for leaving current job (in the presence/absence of formal care unmet needs). We use data from the Eurobarometer 67.3 for 18 European countries and estimate a three simultaneous equations model taking into account the potential endogeneity of labor participation and formal care unmet needs and assuming non-zero correlation among the error terms of the three equations. Results show that individuals who anticipate that becoming...
Source: International Journal of Health Care Finance and Economics - January 21, 2015 Category: Health Management Source Type: research

Physicians’ balance billing, supplemental insurance and access to health care
Abstract Some countries allow physicians to balance bill patients, that is, to bill a fee above the one that is negotiated with, and reimbursed by the health authorities. Balance billing is known for restricting access to physicians’ services while supplemental insurance against balance billing amounts is supposed to alleviate the access problem. This paper analyzes in a theoretical setting the consequences of balance billing on the fees setting and on the inequality of access among the users of physicians’ services. It also shows that supplemental insurance against the expenses associated with balanc...
Source: International Journal of Health Care Finance and Economics - January 20, 2015 Category: Health Management Source Type: research

Effectiveness of micro health insurance on financial protection: Evidence from India
Abstract Iatrogenic poverty caused by inadequate public expenditure on health, lack of social health insurance and low penetration of private health insurance can be mitigated by micro health insurance (MHI) schemes that provide financial protection. The empirical evidence on the impact of MHI on financial protection is limited in India. This paper elucidates the effect of Sampoorna Suraksha Programme (SSP), a MHI scheme in Karnataka on financial protection. Cross-sectional study was undertaken in Karnataka and the data was gathered from 416 insured, 366 newly insured and 364 uninsured households. The imp...
Source: International Journal of Health Care Finance and Economics - December 24, 2014 Category: Health Management Source Type: research

Eligibility for free GP care and the utilisation of GP services by children in Ireland
Abstract The majority of the Irish population pay the full out-of-pocket price of a GP visit, with only those on low incomes exempt. While there is an extensive literature analysing the impact of the Irish system of eligibility for free GP care on GP visiting rates among adults, there is a lack of evidence for children. Given the importance of socio-economic health inequalities in shaping the future outcomes of children, it is important to analyse the extent to which the current system of eligibility leads to inequities in access to GP services among Irish children. In addition, some private health insura...
Source: International Journal of Health Care Finance and Economics - December 9, 2014 Category: Health Management Source Type: research

Have health insurance reforms in Tunisia attained their intended objectives?
Abstract A growing number of developing countries are currently promoting health system reforms with the aim of attaining ‘ universal health coverage’ (UHC). In Tunisia, several reforms have been undertaken over the last two decades to attain UHC with the goals of ensuring financial protection in health and enhancing access to healthcare. The first of these goals has recently been addressed in a companion paper by Abu-Zaineh et al. (Int J Health Care Financ Econ 13(1):73–93, 2013). The present paper seeks to assess whether these reforms have in fact enhanced access to healthcare. The average treatme...
Source: International Journal of Health Care Finance and Economics - December 3, 2014 Category: Health Management Source Type: research

Payment schemes and cost efficiency: evidence from Swiss public hospitals
Abstract This paper aims at analysing the impact of prospective payment schemes on cost efficiency of acute care hospitals in Switzerland. We study a panel of 121 public hospitals subject to one of four payment schemes. While several hospitals are still reimbursed on a per diem basis for the treatment of patients, most face flat per-case rates—or mixed schemes, which combine both elements of reimbursement. Thus, unlike previous studies, we are able to simultaneously analyse and isolate the cost-efficiency effects of different payment schemes. By means of stochastic frontier analysis, we first estimate a...
Source: International Journal of Health Care Finance and Economics - December 1, 2014 Category: Health Management Source Type: research

Health care expenditure decisions in the presence of devolution and equalisation grants
Abstract In a model where health care provision, its regional distribution and the equalisation grant are the result of a utilitarian bargaining between a (relatively) rich region and a poor one, a First Best solution can be reached only if the two Regions have the same bargaining power. From a policy point of view, our model may explain the observed cross-national differences in the redistributive power of health care expenditure and it suggests that to equalise resources across Regions an income based equalisation grant may be preferred because it causes less distortions than an expenditure based one....
Source: International Journal of Health Care Finance and Economics - September 30, 2014 Category: Health Management Source Type: research

Changing healthcare capital-to-labor ratios: evidence and implications for bending the cost curve in Canada and beyond
Abstract Healthcare capital-to-labor ratios are examined for the 10 provincial single-payer health care plans across Canada. The data show an increasing trend–particularly during the period 1997–2009 during which the ratio as much as doubled from 3 to 6 %. Multivariate analyses indicate that every percentage point uptick in the rate of increase in this ratio is associated with an uptick in the rate of increase of real per capita provincial government healthcare expenditures by approximately $31 ( \(p <\) ...
Source: International Journal of Health Care Finance and Economics - September 30, 2014 Category: Health Management Source Type: research

The impact of global budgeting on treatment intensity and outcomes
Abstract This paper investigates the effects of global budgets on the amount of resources devoted to cardio-cerebrovascular disease patients by hospitals of different ownership types and these patients’ outcomes. Theoretical models predict that hospitals have financial incentives to increase the quantity of treatments applied to patients. This is especially true for for-profit hospitals. If that’s the case, it is important to examine whether the increase in treatment quantity is translated into better treatment outcomes. Our analyses take advantage of the National Health Insurance of Taiwan’s impl...
Source: International Journal of Health Care Finance and Economics - September 30, 2014 Category: Health Management Source Type: research

Does a global budget superimposed on fee-for-service payments mitigate hospitals’ medical claims in Taiwan?
This study uses a stays-hospitals-years database comprising acute myocardial infarction inpatients to examine whether the reimbursement policy mitigates the medical benefits claimed to a third-payer party during 2000–2008. The estimated results of a nested random-effects model showed that hospitals attempted to increase their medical benefit claims under the influence of initial implementation of global budgeting. The magnitudes of hospitals’ responses to global budgeting were significantly attributed to hospital ownership, accreditation status, and market competitiveness of a region. The results imply that the regiona...
Source: International Journal of Health Care Finance and Economics - September 30, 2014 Category: Health Management Source Type: research

Payment generosity and physician acceptance of Medicare and Medicaid patients
Abstract Using 2008 physician survey data, we estimate the relationship between the generosity of fees paid to primary care physicians under Medicaid and Medicare and his/her willingness to accept new patients covered by Medicaid, Medicare, or both programs (i.e., dually enrolled patients). Findings reveal physicians are highly responsive to fee generosity under both programs. Also, their willingness to accept patients under either program is affected by the generosity of fees under the other program, i.e., there are significant spillover effects between Medicare and Medicare fee generosity. We also sim...
Source: International Journal of Health Care Finance and Economics - September 30, 2014 Category: Health Management Source Type: research