Feldman R, Greenberg W
Health Serv Res. 1981 Summer;16(2):176-83.
This paper examines two components of the hospital insurance market structure-market share and the absolute number of enrollees in Blue Cross plans-to ascertain whether market structure affects the willingness of Blue Cross plans to use cost control measure. Empirical estimates show that larger plans are more likely to use prospective reimbursement, pre-admission testing, and concurrent review. Market share, however, has a positive effect only on concurrent review. We suggest that there are economies of scale to cost control efforts, but that high market share generally does not lead to increased cost-consciousness.
本文研究了医院保险市场结构的两个组成部分——市场份额和蓝十字计划的参保者绝对数量，以确定市场结构是否会影响蓝十字计划采用成本控制措施的意愿。实证估计表明，规模较大的计划更有可能采用前瞻性报销、入院前检查和同步审查。然而，市场份额仅对同步审查有积极影响。我们认为，成本控制措施存在规模经济，但高市场份额通常不会导致成本意识的提高。
