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The Contribution of Managed Care to the Performance of Healthcare Systems — Evidence from Three Countries
Swiss Journal of Economics and Statistics volume 144, pages 477–493 (2008)
Summary
This paper applies the five standard economic performance criteria to gauge the contribution of Managed Care (MC) to the performance of three healthcare systems, viz. Germany, the Netherlands, and Switzerland. The criteria are (1) matching of consumer preferences, (2) technical efficiency, (3) adaptive capacity, (4) dynamic efficiency, and (5) a rent-free distribution of income that provides incentives for producers to attain criteria (1) through (4). Being insurance-based, the German, Dutch, and Swiss healthcare systems comprise three contractual relationships that can be judged in the light of these criteria. The maximum contribution of MC to the performance of the healthcare system is found for the Netherlands followed by Switzerland. The Independent Practice Associations representing MC in the Netherlands, and the Health Maintenance Organizations representing MC in Switzerland score 15 respectively 6 out of 30 points. By way of contrast, the contribution of the Disease Management Programs to the performance of the German healthcare system remains limited (3 out of 30 points).
References
Amelung, Volker E. (2007), Managed Care: Neue Wege im Gesundheitsmanagement, Wiesbaden.
Bag, Bundesamt für Gesundheit (2007), Statistik der obligatorischen Krankenversicherung 2006, Bern.
Baur, Rita, Heimer, Andreas and Silvia Wieseler (2001), “Health Care Systems and Reform Efforts, an International Comparison”, in: Jan Böcken, Martin Butzlaff and Andreas Esche (eds.), Reforming the Health Sector, Gütersloh, pp. 23–136.
Becker, Karolin, Brändle, Angelika and Peter Zweifel (2007), „Das Discrete-Choice-Experiment“, in: Jan Böcken, Katharina Janus, Uwe Schwenk and Peter Zweifel (eds.), Neue Versorgungsmodelle im Gesundheitswesen, Gütersloh, pp. 38–151.
Bmj, Bundesministerium der Justiz (2006), Soziales fünftes Gesetzbuch —Gesetzliche Krankenversicherung, available at: http://www.gesetze-im-internet.de (April 2008).
Bmg, Bundesministerium für Gesundheit (2007), Die Gesundheitsreform: Infographiken, available at: http://www.diegesundheitsreform.de (May 2008).
Busse, Rheinardt (2004), “Disease Management Programs in Germany’s Statutory Health Insurance System — A Gordian Solution to the Adverse Selection of Chronically Ill People in Competitive Markets?”, Health Affairs, 23 (3), pp. 56–67.
Cutler, David M., McClellan, Mark and Joseph P. Newhouse (2000), “How Does Managed Care Do It?”, Rand Journal of Economics, 31 (3), pp. 526–548.
Cutler, David M. (2002), “Equality, Efficiency, and Market Fundamental: The Dynamics of International Medical-care Reform”, Journal of Economic Literature, 40 (3), pp. 881–906.
Douven, Rudy, Mot, Esther and Marc Pomp (2007), “Health Care Reform in the Netherlands”, Die Volkswirtschaft, 3, pp. 31–33.
Exter, Andréden, Hermans, Herbert, Dosljak, Milena and Reinhardt Busse (2004), Health Care Systems in Transition: Netherlands, Copenhagen, WHO Regional Office for Europe on behalf of the European Observatory on Health systems and Policy.
Felder, Stefan (2003), “Managed Care: Low Reputation but most Effective”, DICE-Report Journal for Institutional Comparisons, 1 (3), pp. 15–19.
Finsterwald, Daniel (2004), „Managed Care — Pionierland Schweiz“, Schriftenreihe der Schweizerischen Gesellschaft für Gesundheitspolitik, 75.
Greiner, Wolfgang (2005), “Health Economic Evaluation of Disease Management Programs — the German Example”, European Journal of Health Economics, 6 (3), pp. 191–196.
Jacobs, Klaus and Sabine Schulze (2006), „Vertragswettbewerb: Mehr Freiheit bei der Partnerwahl”, Gesundheit und Gesellschaft, 7, pp. 36–41.
Lehmann, Hans-Jörg and Peter Zweifel (2004), “Innovation and Risk Selection in Deregulated Social Health Insurance”, Journal of Health Economics, 23, pp. 997–1012.
Manning, Willard G., Leibowitz, Arleen, Goldberg, George A., Rogers, William H. and Joseph P. Newhouse (1984), “A Controlled Trial of the Effect of a Prepaid Group Practice on the Use of Services”, New England Journal of Medicine, 310 (23), pp. 1505–1510.
Schreyögg, Jonas, Stargardt, Tom, Velasco-Garrido, Marcial and Reinhardt Busse (2005), “Defining the Health Benefit Basket in Nine European Countries”, European Journal of Health Economics, 6 (S1), pp. 2–10.
Schut, Frederik T. and Wynand P. M. M. van de Ven (2005), “Rationing and Competition in the Dutch Health Care System”, Health Economics, 14 (S1), pp. 59–74.
Who (2005), Statistical Information System, Statistics 2005.
Wiechmann, Michael (2003), Managed Care: Grundlagen, internationale Erfahrungen und Umsetzung im deutschen Gesundheitswesen, Wiesbaden.
Zweifel, Peter and Friedrich Breyer (1997), Health Economics, New York.
Zweifel, Peter (1998), “Managed Care in Germany and Switzerland: Two Approaches to a Common Problem”, Pharmacoeconomics, 14 (S1), pp. 1–8.
Zweifel, Peter (2006), “Building a Competitive Insurance System: Switzerland’s Strategy for Managed-Care Health Care”, Pharmacoeconomics, 24 (S2), pp. 109–117.
Zweifel, Peter, Telser, Harry, and Stefan Vaterlaus (2006), “Consumer Resistance Against Regulation: The Case of Health Care”, Journal of Regulatory Economics, 29, pp. 319–332.
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The authors thank Philippe Widmer, Boris Krey, Maria Trottmann, Karolin Becker, and participants of the 2008 Annual Meeting of the SSES for helpful comments. The support of the Association af Pharma Importers in Switzerland (VIPS) is gratefully acknowledged.
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Schoder, J., Zweifel, P. The Contribution of Managed Care to the Performance of Healthcare Systems — Evidence from Three Countries. Swiss J Economics Statistics 144, 477–493 (2008). https://doi.org/10.1007/BF03399263
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DOI: https://doi.org/10.1007/BF03399263