Disclosing doctors' incentives: Will consumers understand and value the information?

Health Affairs

Volumn 19, Issue 4, 2000, Pages 149-155

  Miller, Tracy E ^a   Horowitz, Carol R ^b  

^a MOUNT SINAI SCHOOL OF MEDICINE   (United States)

^b Department of Health Policy ^*  (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; ATTITUDE TO HEALTH; DOCTOR PATIENT RELATION; ECONOMICS; EMPIRICAL APPROACH; HEALTH CARE AND PUBLIC HEALTH; HEALTH CARE POLICY; HEALTH INSURANCE; HUMAN; INFORMATION PROCESSING; INFORMATION SERVICE; INTERPERSONAL COMMUNICATION; LEGAL ASPECT; PATIENT ATTITUDE; PERSONNEL MANAGEMENT; SOCIAL BEHAVIOR; UNITED STATES;

EMPIRICAL APPROACH; HEALTH CARE AND PUBLIC HEALTH;

ATTITUDE TO HEALTH; DISCLOSURE; FOCUS GROUPS; HEALTH POLICY; HUMANS; INFORMATION SERVICES; MANAGED CARE PROGRAMS; PATIENT ACCEPTANCE OF HEALTH CARE; PHYSICIAN INCENTIVE PLANS; PHYSICIAN-PATIENT RELATIONS; SOCIAL RESPONSIBILITY; UNITED STATES;

EID: 0034220136     PISSN: 02782715     EISSN: None     Source Type: Journal    
DOI: 10.1377/hlthaff.19.4.149     Document Type: Article

References (26)

1. T.E. Miller and W.M. Sage, "Disclosing Physician Financial Incentives," Journal of the American Medical Association 281, no. 15 (1999): 1424-1430; and F.J. Hellinger, "Regulating the Financial Incentives Facing Physicians in Managed Care Plans," American Journal of Managed Care 4 (1998): 663-674.
2. T.E. Miller and W.M. Sage, "Disclosing Physician Financial Incentives," Journal of the American Medical Association 281, no. 15 (1999): 1424-1430; and F.J. Hellinger, "Regulating the Financial Incentives Facing Physicians in Managed Care Plans," American Journal of Managed Care 4 (1998): 663-674.
3. For example, Elhmann v Kaiser Foundation Health Plan of Texas et al 198 F.3d 552 (2000); and Neade v Portes, 303 III.App. 3d 799 (1999).
4. Shea v Esensten, 107 F.3d 625 (8th Cir. 1997).
5. Ehlmann v Kaiser Foundation Health Plans of Texas. Litigation now pending before the U.S. Supreme Court asserting that use of incentives to minimize utilization violated the fiduciary duty under ERISA may also spur disclosure nationally. Hedrich v Pegram, 154 F.3d 362, cert. granted, 1999 U.S. Lexis 4742 (1999).
6. American Medical Association, Council on Ethical and Judicial Affairs, "Ethical Issues in Managed Care," Journal of the American Medical Association 273, no. 4 (1995): 330-335.
7. Miller and Sage, "Disclosing Physician Financial Incentives"; M.A. Rodwin, "Consumer Protection and Managed Care: The Need for More Organized Consumers," Health Affairs (Fall 1996): 110-123; and M.A. Hall, "Informed Consent to Rationing Decisions," Milbank Quarterly 71, no. 4 (1993): 645-668.
8. Miller and Sage, "Disclosing Physician Financial Incentives"; M.A. Rodwin, "Consumer Protection and Managed Care: The Need for More Organized Consumers," Health Affairs (Fall 1996): 110-123; and M.A. Hall, "Informed Consent to Rationing Decisions," Milbank Quarterly 71, no. 4 (1993): 645-668.
9. Miller and Sage, "Disclosing Physician Financial Incentives"; M.A. Rodwin, "Consumer Protection and Managed Care: The Need for More Organized Consumers," Health Affairs (Fall 1996): 110-123; and M.A. Hall, "Informed Consent to Rationing Decisions," Milbank Quarterly 71, no. 4 (1993): 645-668.
10. D.F. Levinson, "Toward Full Disclosure of Referral Restrictions and Financial Incentives by Prepaid Health Plans," New England Journal of Medicine 317, no. 27 (1987): 1729-1731.
11. A.L. Hillman , W.P. Welch, and M.V. Pauly, "Contractual Arrangements between HMOs and Primary Care Physicians: Three-Tiered HMOs and Risk Pools," Medical Care 30, no. 2 (1992): 136-148; and B.E Landon, I.B. Wilson, and P.D. Cleary, "A Conceptual Model of the Effects of Health Care Organizations on the Quality of Medical Care," Journal of the American Medical Association 279, no. 17 (1998): 1377-1382.
12. A.L. Hillman , W.P. Welch, and M.V. Pauly, "Contractual Arrangements between HMOs and Primary Care Physicians: Three-Tiered HMOs and Risk Pools," Medical Care 30, no. 2 (1992): 136-148; and B.E Landon, I.B. Wilson, and P.D. Cleary, "A Conceptual Model of the Effects of Health Care Organizations on the Quality of Medical Care," Journal of the American Medical Association 279, no. 17 (1998): 1377-1382.
13. R.H. Miller and H.S. Luft, "Managed Care Plan Performance since 1980: A Literature Analysis," Journal of the American Association 271, no. 19 (1996): 1512-1519; C.B. Cangialose et al., "Impact of Managed Care on Quality of Healthcare: Theory and Evidence," American Journal of Managed Care 3, no. 8 (1997): 1153-1170; and D.M. Berwick, "Payment of Capitation and the Quality of Care," New England Journal of Medicine 335, no. 16 (1996): 1227-1230.
14. R.H. Miller and H.S. Luft, "Managed Care Plan Performance since 1980: A Literature Analysis," Journal of the American Association 271, no. 19 (1996): 1512-1519; C.B. Cangialose et al., "Impact of Managed Care on Quality of Healthcare: Theory and Evidence," American Journal of Managed Care 3, no. 8 (1997): 1153-1170; and D.M. Berwick, "Payment of Capitation and the Quality of Care," New England Journal of Medicine 335, no. 16 (1996): 1227-1230.
15. R.H. Miller and H.S. Luft, "Managed Care Plan Performance since 1980: A Literature Analysis," Journal of the American Association 271, no. 19 (1996): 1512-1519; C.B. Cangialose et al., "Impact of Managed Care on Quality of Healthcare: Theory and Evidence," American Journal of Managed Care 3, no. 8 (1997): 1153-1170; and D.M. Berwick, "Payment of Capitation and the Quality of Care," New England Journal of Medicine 335, no. 16 (1996): 1227-1230.
16. T.H. Gallagher, A. Alpers, and B. Lo, "Health Care Financing Administration's New Regulations for Financial Incentives in Medicaid and Medicare Managed Care: One Step Forward?" American Journal of Medicine (November 1998): 409-415;
17. D. Mechanic and M. Schlesinger, "The Impact of Managed Care on Patients' Trust in Medical Care and Their Physicians," Journal of the American Medical Association 275, no. 21 (1996): 1693-1697;
18. and R.J. Blendon et al., "Understanding the Managed Care Backlash," Health Affairs (July/Aug 1998): 80-94.
19. A.C. Kao et al., "The Relationship between Method of Physician Payment and Patient Trust," Journal of the American Medical Association 280, no. 19 (1998): 1708-1714.
20. A.C. Kao et al., "Physician Incentives and Disclosure of Payment Methods to Patients" (Unpublished manuscript).
21. S.L. Isaacs, "Consumers' Information Needs: Results of a National Survey," Health Affairs (Winter 1996): 31-41.
22. J.H. Hibbard et al., "Can Medicare Beneficiaries Make Informed Choices?" Health Affairs (Nov/Dec 1998): 181-193.
23. Kao et al., "The Relationship between Method of Physician Payment and Patient Trust."
24. This is consistent with a large telephone survey of Medicare beneficiaries. See Hibbard et al., "Can Medicare Beneficiaries Make Informed Choices?"
25. M.A. Hall, K.E. Kidd, and E. Dugan, "Disclosure of Physician Incentives: Do Practices Satisfy Purposes?" Health Affairs (July/Aug 2000): 156-164.
26. Ibid. Health plan leaders say the need to meet regulatory requirements is the predominant motivation for disclosure of financial incentives and the key consideration in designing content.