Boonen Lieke H H M, Schut Frederik T, Koolman Xander
Institute of Health Policy and Management, Erasmus University of Rotterdam, Rotterdam, The Netherlands.
Health Econ. 2008 Mar;17(3):299-316. doi: 10.1002/hec.1265.
Consumer channeling is an important element in the insurer-provider bargaining process. Health insurers can influence provider choice by offering insurance contracts with restricted provider networks. Alternatively, they can offer contracts with unrestricted access and use incentives to motivate consumers to visit preferred providers. Little is known, however, about the effectiveness of this alternative strategy of consumer channeling. Using data from two natural experiments in the Dutch pharmacy market, we examine how consumers respond to incentives used by health insurers to influence their choice of provider. We find that consumers are sensitive to rather small incentives and that temporary incentives may sort a long-term effect on provider choice. In addition, we find that both consumer and provider characteristics determine whether consumers are willing to switch to preferred pharmacies.
消费者引导是保险公司与医疗服务提供者谈判过程中的一个重要因素。健康保险公司可以通过提供与受限医疗服务提供者网络的保险合同来影响消费者对医疗服务提供者的选择。或者，他们可以提供无限制就诊机会并使用激励措施来促使消费者前往首选的医疗服务提供者处就诊。然而，对于这种消费者引导的替代策略的有效性，人们了解甚少。利用荷兰药品市场两项自然实验的数据，我们研究了消费者如何应对健康保险公司用来影响其医疗服务提供者选择的激励措施。我们发现消费者对相当小的激励措施很敏感，而且临时激励措施可能会对医疗服务提供者的选择产生长期影响。此外，我们发现消费者和医疗服务提供者的特征都决定了消费者是否愿意转而选择首选药店。
