Using Subjective Risk Adjusting to Prevent Patient Dumping in the Health Care Industry

B-Tier
Journal: Journal of Economics & Management Strategy
Year: 1999
Volume: 8
Issue: 3
Pages: 351-382

Score contribution per author:

1.005 = (α=2.01 / 2 authors) × 1.0x B-tier

α: calibrated so average coauthorship-adjusted count equals average raw count

Abstract

We examine how to procure health care services at minimum cost while preventing suppliers from refusing to care for high‐cost patients. A single risk‐adjusted prospective payment is optimal only when it is particularly costly for the supplier to discover likely treatment costs. Cost sharing is optimal when these screening costs are somewhat smaller. When screening costs are sufficiently small, screening is optimally accommodated and subjective risk adjusting is implemented. Under subjective risk adjusting, the supplier classifies patients according to his personal assessment of likely treatment costs, and payments are structured accordingly. Optimal procurement policies are contrasted with prevailing industry policies.

Technical Details

RePEc Handle
repec:bla:jemstr:v:8:y:1999:i:3:p:351-382
Journal Field
Industrial Organization
Author Count
2
Added to Database
2026-01-25