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Managed care and physician work effort.

Liao, Junlin.

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Managed care and physician work effort.

紀錄類型:	書目-語言資料,印刷品 : Monograph/item
正題名/作者:	Managed care and physician work effort./
作者:	Liao, Junlin.
面頁冊數:	123 p.
附註:	Adviser: John Schneider.
Contained By:	Dissertation Abstracts International68-09B.
標題:	Economics, Labor. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3281380
ISBN:	9780549234487

Managed care and physician work effort.
Liao, Junlin.

Managed care and physician work effort. - 123 p.

Adviser: John Schneider.

Thesis (Ph.D.)--The University of Iowa, 2007.

We developed an analytical model to explain the effect of managed care and capitation on physician productivity. The model predicts that the market-level managed care reduces physician work effort because of the efficient utilization target. With market-level managed care and other factors controlled for, practice-level managed care should increase physician work effort. Managed care promotes primary care with a higher efficient utilization target for PCPs, however, the ultimate impact on physician work is dependent on the combined effect of a higher utilization target and additional service quantity increase because of price drop and inducement. We expect the effects of managed care on physician earnings to parallel the effects on physician work effort.

ISBN: 9780549234487Subjects--Topical Terms:

1019135
Economics, Labor.

Managed care and physician work effort.
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520 $a We developed an analytical model to explain the effect of managed care and capitation on physician productivity. The model predicts that the market-level managed care reduces physician work effort because of the efficient utilization target. With market-level managed care and other factors controlled for, practice-level managed care should increase physician work effort. Managed care promotes primary care with a higher efficient utilization target for PCPs, however, the ultimate impact on physician work is dependent on the combined effect of a higher utilization target and additional service quantity increase because of price drop and inducement. We expect the effects of managed care on physician earnings to parallel the effects on physician work effort.
520 $a Through trend analysis, ANOVA, and unbalanced panel regression, we find the negative effect of managed care on physician work effort. It is found that every 10% increase in HMO penetration leads to about 40 hours, 2%, reduction for specialists and 66 hours, 3%, reduction for primary care physicians in patient care hours. The effect on the practice level is dependent on market level HMO penetration. Practice-level managed care increases physician work effort when market HMO penetration is beyond 20 &sim; 30%. Physicians with an average number of managed care contracts work about 4.2% more than physicians without managed care contracts. The effects observed on physician earnings parallel those effects on work effort except by physician specialty status. We find that the effect of price change and inducement dominate that of higher utilization target by managed care, although managed care is trying to increase PCPs' earnings. Reduction in physician work effort is more prominent with primary care physicians.
520 $a It is concluded that the theoretical model proposed by this study is valid. Although managed care is associated with market level reduction of physician earnings and subsequently work effort, it does provide some incentive on individual basis to increase physician work effort. The effort of managed care to promote primary care cannot offset the influence of price change and physician agency characteristics. Managed care introduces greater work disincentive for PCPs than specialists.
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