Wu Vivian Y
University of Southern California and RAND Corporation, Los Angeles, CA 90089, United States.
J Health Econ. 2009 Mar;28(2):350-60. doi: 10.1016/j.jhealeco.2008.11.001. Epub 2008 Nov 13.
Research has shown that managed care (MC) slowed the rate of growth in health care spending in the 1990s, primarily via lower unit prices paid. However, the mechanism of MC's price bargaining has not been well studied. This article uses a unique panel dataset with actual hospital prices in Massachusetts between 1994 and 2000 to examine the sources of MC's bargaining power. I find two significant determinants of price discounts. First, plans with large memberships are able to extract volume discounts across hospitals. Second, health plans that are more successful at channeling patients can extract greater discounts. Patient channeling can add to the volume discount that plans negotiate.
研究表明，管理式医疗（MC）在20世纪90年代减缓了医疗保健支出的增长速度，主要是通过降低支付的单价。然而，MC的价格谈判机制尚未得到充分研究。本文使用一个独特的面板数据集，其中包含1994年至2000年马萨诸塞州医院的实际价格，以研究MC议价能力的来源。我发现了价格折扣的两个重要决定因素。首先，会员众多的计划能够在各医院获得批量折扣。其次，在引导患者方面更成功的健康计划能够获得更大的折扣。患者引导可以增加计划谈判获得的批量折扣。
