Technological innovation in medical services can improve health, but its ability to reach patients often depends on price signals for downstream providers, which can also be discordant across production inputs. We examine such a context when Medicare sharply revises facility fees--while holding...

Many health economists demand more competition in the health care system. They focus on the competition between sickness funds for insured and the competition between health care providers for contracts with sickness funds. But they neglect the competition between health care providers for...

This paper investigate the causal e ect of a regulation for California nursing homes that required a minimum number of nurse hours per patient day on the quality of health care measured both by patient outcomes and de ciency citations from facility inspections. The research design employed is...

Regulation fostering Managed Care alternatives in health insurance is spreading. This work reports on an experiment designed to measure the amounts of compensation asked by the Swiss population (in terms of reduced premiums) for Managed-Care type restrictions in the provision of health care. It...

Competition plays an ambiguous role in nursing home markets where public and private payers coexist. Using U.S. nursing home data with a wide range of market structures, we find a U-shaped relationship between competition and service quality when nursing homes serve a mix of public and private...

Medicare Accountable Care Organizations (ACOs) represent the nation’s largest initiative of Medicare alternative payment models toward value and health outcomes. The Centers for Medicare & Medicaid Services (CMS) have tested various ACO models with differential risk structures, and have issued...

We consider how purchasers and providers negotiate the quality element of contracts when the purchasers are required to link a fixed proportion of revenue to quality. A simple model predicts that the complexity of the quality element will depend on purchaser and provider characteristics. Using...

Many new methods for measuring the quality of health care have been devised since 1970. For the past ten years, the health care field has been struggling to integrate industrial models into its quality improvement systems. In order to judge whether regulation has evolved in tandem with these...

Regulation fostering Managed Care alternatives in health insurance is spreading. This work reports on an experiment designed to measure the amounts of compensation asked by the Swiss population (in terms of reduced premiums) for Managed-Care type restrictions in the provision of health care. It...

Regulators are testing many payment reforms to improve US healthcare productivity. The vast majority of these reforms allow market participants to opt in rather than mandating participation. Allowing choice can enhance outcomes if firms select contracts based on unobserved treatment gains....