Risk selection and cost shifting in a prospective physician payment system: Evidence from Ontario

Health Policy

Volumn 115, Issue 2-3, 2014, Pages 249-257

  Kantarevic, Jasmin ^a   Kralj, Boris ^a  

^a Ontario Medical Association   (Canada)

Author keywords

Capitation; Cream skimming; Physician remuneration; Primary care; Risk selection

Indexed keywords

ADULT; ARTICLE; CANADA; CAPITATION FEE; CONTROLLED STUDY; DECISION MAKING; FEMALE; HEALTH CARE COST; HUMAN; MAJOR CLINICAL STUDY; MALE; MEDICAL FEE; MIDDLE AGED; PHYSICIAN; PHYSICIAN ATTITUDE; PROSPECTIVE PAYMENT; REIMBURSEMENT; RISK MANAGEMENT; COST; ECONOMICS; EPIDEMIOLOGY; ORGANIZATION AND MANAGEMENT; PROCEDURES; RISK ASSESSMENT; STATISTICAL MODEL; STATISTICS AND NUMERICAL DATA;

CAPITATION FEE; COST ALLOCATION; FEMALE; HEALTH EXPENDITURES; HUMANS; MALE; MIDDLE AGED; MODELS, ECONOMIC; ONTARIO; PHYSICIANS; PROSPECTIVE PAYMENT SYSTEM; RISK ASSESSMENT;

EID: 84895918849     PISSN: 01688510     EISSN: 18726054     Source Type: Journal    
DOI: 10.1016/j.healthpol.2013.10.002     Document Type: Article

References (20)

1. Barros P.P. Cream-skimming, incentives for efficiency and payment system. Journal of Health Economics 2003, 22:419-443.
2. Blundell R., Costa Dias M. Alternative approaches to evaluation in empirical microeconomics. Journal of Human Resources 2009, 44:565-640.
3. Chalkley M., Malcomson J. Contracting for health services when patient demand does not reflect quality. Journal of Health Economics 1998, 17:1-19.
4. Ellis R.P. Risk adjustment in health care markets: concepts and applications. Financing health care: new ideas for a changing society 2008, Wiley. M. Lu, E. Jonsson (Eds.).
5. Ellis R. Creaming, skimping and dumping: provider competition on the intensive and extensive margins. Journal of Health Economics 1998, 17:537-555.
6. Ellis R.P., McGuire T.G. Provider behavior under prospective reimbursement: cost sharing and supply. Journal of Health Economics 1986, 5:129-151.
7. Ellis R.P., McGuire T.G. Optimal payment systems for health services. Journal of Health Economics 1990, 9:375-396.
8. Hutchison B., Buckley N.J., Hurley J., Contoyannis P., Ruskova A., Buckley G., et al. Needs-adjusted primary care capitation payment: development and comparison of models. Final Report to the Ontario Ministry of Health and Long-Term Care and the Needs-Adjusted Primary Care Capitation Funding Stakeholder Working Group 2006.
9. Imbens G.W., Wooldridge J.M. Recent developments in the econometrics of program evaluation. Journal of Economic Literature 2009, 47:5-86.
10. Kantarevic J., Kralj B. Link between physician payment models and pay for performance incentives: the case of diabetes management incentive in Ontario. Health Economics 2013, 22(12). (in press).
11. Kralj B., Kantarevic J. Quality and quantity in primary care mixed payment models: evidence from Family Health Organizations in Ontario. Canadian Journal of Economics 2013, 46:208-238.
12. Léger P.T. Physician payment mechanisms. Financing health care: new ideas for a changing society 2008, Wiley. M. Lu, E. Jonsson (Eds.).
13. Lee D.S., Lemieux T. Regression discontinuity designs in economics. Journal of Economic Literature 2010, 48:281-355.
14. Li J, Hurley J, DeCicca P, Buckley G. Physician response to pay-for-performance-evidence from a natural experiment. NBER Working Paper 16909; 2011.
15. Ma C.A. Health care payment systems: cost and quality incentives. Journal of Economics and Management Strategy 1994, 3:93-112.
16. McGuire T. Physician agency. Handbook of health economics 2000, Elsevier, Amsterdam. A.J. Culyer, J.P. Newhouse (Eds.).
17. Meyer B.D. Natural and quasi-experiments in economics. Journal of Business and Economic Statistics 1995, 13:151-161.
18. Scott A. Economics of general practice. Handbook of health economics 2000, Elsevier, Amsterdam. A.J. Culyer, J.P. Newhouse (Eds.).
19. Van de Ven W.P.M.M., Ellis R.P. Risk adjustment in competitive health plan markets. Handbook of health economics 2000, Elsevier, Amsterdam. A.J. Culyer, J.P. Newhouse (Eds.).
20. Zweifel P., Breyer F., Kiffman M. Health economics 2009, Berlin, Springer-Verlag.