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Q: What are some of the driving forces behind rising health care spending? How do HMOs affect health care costs? What key functions and incentives of HMOs affect costs?
A: We use unique proprietary data from an HMO network to analyze the effect of incentives on medical costs and quality. [ [ We report three findings: (1) costs fall as financial incentives to control costs increase; (2) non-financial features of the incentive system (notably peer-pressure and mutual monitoring among physicians) may also influence costs; and (3) financial incentives can also elicit
improvements in measured quality when quality measures are included in the incentive system. ] Note: The HMO we study runs a network of independent providers. In this network, primary care physicians are not employees of the HMO. Rather they are independent agents who sign contracts with the HMO. [ The primary care physicians in the network act as ?gatekeepers? who determine the use of resources. Our focus on networks of independent providers is important. These organizations are rarely studied yet they comprise one of the largest segments of the managed care market. Networks of this type are also worthy of special attention because their incentive systems differ in important ways from those found in other types of health care organizations. ]
scijoe21|Points 1805|
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Asked 6/28/2012 6:14:36 PM
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