Insurer-provider integration, credible commitment, and managed-care backlash

Nolan H. Miller

doi:10.1016/j.jhealeco.2005.12.007

Insurer-provider integration, credible commitment, and managed-care backlash

Research output: Contribution to journal › Article › peer-review

Abstract

People distrust managed care organizations (MCOs) more than traditional health plans. This phenomenon has become known as "managed-care backlash." Using a model of the interaction between insurers, physicians, and patients, this paper identifies two possible motivations for MCO backlash. The first, which comes from traditional health plans' superior ability to credibly commit to providing better than least-cost care, is efficiency promoting. The second, which arises when patients are able to obtain higher-benefit treatments through reneging on their initial insurance contracts through "doctor shopping," may reduce efficiency.

Original language	English (US)
Pages (from-to)	861-876
Number of pages	16
Journal	Journal of Health Economics
Volume	25
Issue number	5
DOIs	https://doi.org/10.1016/j.jhealeco.2005.12.007
State	Published - Sep 2006
Externally published	Yes

Keywords

Managed-care backlash
Moral hazard
Provider incentives

ASJC Scopus subject areas

Health Policy
Public Health, Environmental and Occupational Health

Online availability

10.1016/j.jhealeco.2005.12.007

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Cite this

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AB - People distrust managed care organizations (MCOs) more than traditional health plans. This phenomenon has become known as "managed-care backlash." Using a model of the interaction between insurers, physicians, and patients, this paper identifies two possible motivations for MCO backlash. The first, which comes from traditional health plans' superior ability to credibly commit to providing better than least-cost care, is efficiency promoting. The second, which arises when patients are able to obtain higher-benefit treatments through reneging on their initial insurance contracts through "doctor shopping," may reduce efficiency.

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Insurer-provider integration, credible commitment, and managed-care backlash

Abstract

Keywords

ASJC Scopus subject areas

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