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Multiple Payers in Health Care : A Framework for Assessment

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dc.contributor.authorZweifel, Peter
dc.date.accessioned2013-05-30T18:19:16Z
dc.date.available2013-05-30T18:19:16Z
dc.date.issued2004-09
dc.description.abstractThe starting point of the debate about the pros and cons of multipayer systems is the suspicion that in many health care systems, consumers do not get sufficient value for money. This contribution argues that one cause may be a non-optimal choice of payment systems. Optimal payment of health care providers importantly depends on the amount of information available to the (prospective) patient. If patients have full information about both the effort exerted and the effectiveness of the service provider, the conventional fee-for-service payment is optimal from their point of view. If patients cannot observe true effort exerted while providers are reasonably homogenous with respect to effectiveness, the optimal payment function consists of a fixed payment and a bonus for especially favorable outcomes in terms of health. If the patient in addition does not know whether a given health care provider effective or ineffective, a special informational rent designed to attract the unrecognized favorable type is appropriate. Now, a government is unlikely to come up with payment systems that closely conform to this conditionality, typically preferring single-payer systems that allow service providers to exercise monopsony power and thus keep health care expenditure low. Multiple-payer systems containing competitive health insurers may have an advantage in designing payment systems in a way that maintains or reinforces provider incentives to do the right thing for their patients, resulting in more value for money.en
dc.identifierhttp://documents.worldbank.org/curated/en/2004/09/5643877/multiple-payers-health-care-framework-assessment
dc.identifier.doi10.1596/13704
dc.identifier.urihttps://hdl.handle.net/10986/13704
dc.languageEnglish
dc.language.isoen_US
dc.publisherWorld Bank, Washington, DC
dc.relation.ispartofseriesHealth, Nutrition and Population (HNP) discussion paper;
dc.rightsCC BY 3.0 IGO
dc.rights.holderWorld Bank
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/igo/
dc.subjectACCESS TO HEALTH CARE
dc.subjectAGED
dc.subjectAGENTS
dc.subjectAGING
dc.subjectBEDS
dc.subjectCAPITATION
dc.subjectCONSUMERS
dc.subjectCREAM SKIMMING
dc.subjectDISCRIMINATION
dc.subjectHEALTH CARE
dc.subjectHEALTH CARE FINANCE
dc.subjectHEALTH CARE FINANCING
dc.subjectHEALTH CARE PROVIDER
dc.subjectHEALTH CARE PROVIDERS
dc.subjectHEALTH CARE SECTOR
dc.subjectHEALTH CARE SERVICES
dc.subjectHEALTH CARE SYSTEMS
dc.subjectHEALTH CONDITIONS
dc.subjectHEALTH INSURANCE
dc.subjectHEALTH INSURERS
dc.subjectHEALTH MAINTENANCE ORGANIZATIONS
dc.subjectHEALTH OUTCOMES
dc.subjectHEALTH RISKS
dc.subjectHEALTH SECTOR
dc.subjectHEALTH SERVICES
dc.subjectHEALTH STATUS
dc.subjectHEALTH SYSTEM
dc.subjectHEART SURGERY
dc.subjectHOSPITAL ADMISSION
dc.subjectHOSPITALS
dc.subjectHUMAN DEVELOPMENT
dc.subjectHUMAN RESOURCES
dc.subjectINCOME
dc.subjectINTERVENTION
dc.subjectLATIN AMERICAN
dc.subjectLESSONS LEARNED
dc.subjectLOW-INCOME COUNTRIES
dc.subjectMANAGED CARE
dc.subjectMARGINAL COST
dc.subjectMEDICAID
dc.subjectMEDICAL ASSOCIATIONS
dc.subjectMEDICAL CARE
dc.subjectMEDICAL EQUIPMENT
dc.subjectMEDICAL SERVICES
dc.subjectMEDICAL TECHNOLOGY
dc.subjectMEDICAL TREATMENT
dc.subjectMEDICARE
dc.subjectMOTIVATION
dc.subjectNATIONAL HEALTH INSURANCE
dc.subjectNUTRITION
dc.subjectPATIENTS
dc.subjectPHYSICIANS
dc.subjectPREMIUMS
dc.subjectPRIVATE INSURANCE
dc.subjectPROBABILITY
dc.subjectPROFESSIONAL ASSOCIATIONS
dc.subjectPROGRAMS
dc.subjectPROMOTING HEALTH
dc.subjectPROVIDER INCENTIVES
dc.subjectPUBLIC HEALTH
dc.subjectPUBLIC HEALTH CARE
dc.subjectPUBLIC SECTOR
dc.subjectRATES
dc.subjectRISK AVERSION
dc.subjectSAVINGS
dc.subjectSERVICE DELIVERY
dc.subjectSOCIAL INSURANCE
dc.subjectSOCIAL SECURITY
dc.subjectTHAILAND
dc.subjectWEIGHT
dc.subjectWORKERS
dc.titleMultiple Payers in Health Care : A Framework for Assessmenten
dspace.entity.typePublication
okr.crosscuttingsolutionareaGender
okr.date.doiregistration2025-05-05T12:09:37.452095Z
okr.doctypePublications & Research::Working Paper
okr.doctypePublications & Research
okr.docurlhttp://documents.worldbank.org/curated/en/2004/09/5643877/multiple-payers-health-care-framework-assessment
okr.globalpracticeHealth, Nutrition, and Population
okr.guid324361468780574556
okr.identifier.externaldocumentum000090341_20050307125620
okr.identifier.internaldocumentum5643877
okr.identifier.report31599
okr.language.supporteden
okr.pdfurlhttp://www-wds.worldbank.org/external/default/WDSContentServer/WDSP/IB/2005/03/07/000090341_20050307125620/Rendered/PDF/315990HNP0Zwei1ersinHealthCareFinal.pdfen
okr.topicInsurance and Risk Mitigation
okr.topicHealth Economics and Finance
okr.topicHealth Monitoring and Evaluation
okr.topicHealth Systems Development and Reform
okr.topicGender::Gender and Health
okr.unitHealth, Nutrition, and Population
okr.volume1 of 1
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