Overcoming resistance against managed care – insights from a bargaining model

Andree Ehlert (), Thomas Wein () and Peter Zweifel ()
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Andree Ehlert: Leuphana University of Lueneburg
Thomas Wein: Leuphana University of Lueneburg
Peter Zweifel: Leuphana University of Lueneburg

Health Economics Review, 2017, vol. 7, issue 1, 1-15

Abstract: Abstract Recent healthcare reforms have sought to increase efficiency by introducing managed care (MC) while respecting consumer preferences by admitting choice between MC and conventional care. This article proposes an institutional change designed to let German consumers choose between the two settings through directing payments from the Federal Health Fund to social health insurers (SHIs) or to specialized MC organizations (MCOs). To gauge the chance of success of this reform, a game involving a SHI, a MCO, and a representative insured (RI) is analyzed. In a “three-player/three-cake” game the coalitions {SHI, MCO}, {MCO, RI}, and {SHI, RI} can form. Players’ possibility to switch between coalitions creates new outside options, causing the conventional bilateral Nash bargaining solution to be replaced by the so-called von Neumann-Morgenstern triple. These triples are compared to the status quo (where the RI has no threat potential) and related to institutional conditions characterizing Germany, the Netherlands, and Switzerland.

Keywords: Managed care; Game theory; Multilateral Nash bargaining; Health insurance; Consumer choice; Healthcare reform; Germany; The Netherlands; Switzerland (search for similar items in EconPapers)
JEL-codes: C72 D02 I11 I13 (search for similar items in EconPapers)
Date: 2017
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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DOI: 10.1186/s13561-017-0156-4

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