Hospital-insurer bargaining. An empirical investigation of appendectomy pricing
Hospital-insurer bargaining. An empirical investigation of appendectomy pricing
复制标题
DOI：
10.1016/s0167-6296(96)00536-x
复制
发表时间：
1997-08-01
影响因子：
3.5
通讯作者：
Wong, HS
中科院分区：
文献类型：
--
作者：
Brooks, JM;Dor, A;Wong, HS
雇主对医疗保健成本的敏感性增加，迫使保险公司通过与供应商进行有效的讨价还价来寻求降低成本的方法。哪些因素决定了医院和保险公司之间谈判的价格？医院与保险公司的互动是在讨价还价模型的背景下捕获的，在该模型中，讨价还价的收益被明确定义。选择腰椎切除术是因为它是一种定义明确的手术，临床变异很小。我们的研究结果表明，某些医院的制度安排（如医院附属机构），HMO的渗透，更大的医院集中度提高医院的谈判地位。此外，随着时间的推移，医院的议价能力已经减弱，各州的情况各不相同。(C)1997年Elsevier Science B.V.
Employers' increased sensitivity to health care costs has forced insurers to seek ways to lower costs through effective bargaining with providers. What factors determine the prices negotiated between hospitals and insurers? The hospital-insurer interaction is captured in the context of a bargaining model, in which the gains from bargaining are explicitly defined. Appendectomy was chosen because it is a well-defined procedure with little clinical variation. Our results show that certain hospital institutional arrangements (e.g. hospital affiliations), HMO penetration, and greater hospital concentration improve hospitals' bargaining position. Furthermore, hospitals' bargaining effectiveness has diminished over time and Varies across states. (C) 1997 Elsevier Science B.V.