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Health Service Gatekeepers

James Malcomson

No 1063, CESifo Working Paper Series from CESifo

Abstract: Incentive contracts for gatekeepers who control patient access to specialist medical services provide too weak incentives to investigate cost further when expected cost of treatment is greater than benefit. Making gatekeepers residual claimants with a fixed fee from which treat-ment costs must be met (as with full insurers who are themselves gatekeepers) provides too strong incentives when expected cost is less than benefit. Giving patients the choice between a gatekeeper with an incentive contract and one without is unstable. With one scenario, pa- tients always prefer the latter. With another, patients have incentives to acquire information that makes incentive contracts ineffective.

Keywords: gatekeepers; patient referrals; general practitioners; fundholding; medical insurance; incentive contracts (search for similar items in EconPapers)
Date: 2003
New Economics Papers: this item is included in nep-edu and nep-hea
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Journal Article: Health Service Gatekeepers (2004)
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