Risk sharing and moral hazard under prospective payment to hospitals : how to reimburse services for outlier patients

Details

Serval ID
serval:BIB_397B014B85D1
Type
Report: a report published by a school or other institution, usually numbered within a series.
Publication sub-type
Working paper: Working papers contain results presented by the author. Working papers aim to stimulate discussions between scientists with interested parties, they can also be the basis to publish articles in specialized journals
Collection
Publications
Institution
Title
Risk sharing and moral hazard under prospective payment to hospitals : how to reimburse services for outlier patients
Author(s)
Maréchal François, Mougeot Michel
Publisher
Ecole HEC-DEEP
Institution details
Ecole HEC-DEEP
Address
Lausanne
Issued date
2004
Number
04.03
Genre
Cahiers de recherches économiques
Language
english
Number of pages
21 p.
Notes
Mention de responsabiblité : / François Maréchal and Michel Mougeot SAPHIRID:60349
Abstract
We analyze the regulation of a single health care provider (e.g. a hospital). According to several payment rules used in different countries, we consider a mixed linear payment in which the hospital is paid a fixed price per DRG (diagnosis related group) for most patients (inlier patients) and is reimbursed by a cost sharing payment for patients with exceptionally costly stays (outlier patients). Given this form of payment, we determine the optimal threshold above which to consider a patient as an outlier patient, as well as the optimal payment per DRG and the optimal cost sharing parameter. For the case where the regulator can use a two part tariff, we also determine the fixed charge the regulator has to impose in order to extract hospital rents. [Authors]
Keywords
Financial Management, Hospital , Diagnosis-Related Groups , Risk Sharing, Financial
Create date
14/03/2008 11:21
Last modification date
20/08/2019 14:29
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