ECONOMICS 2 HEALTHCARE MANAGERS THIRD EDITION ROBERT H. LEE AUPHA. Health Administration Press, Chicago, Illinois

Transcription

1 ECONOMICS 2 HEALTHCARE MANAGERS THIRD EDITION ROBERT H. LEE AUPHA Health Administration Press, Chicago, Illinois Association of University Programs in Health Administration, Arlington, Virginia

2 DETAILED CONTENTS Prefa-ce to the Third Edition xv Chapter 1. Why Health Economics? Why Health Economics? Economics as a Map for Decision Making Special Chaiienges for Healthcare Managers Risk and Uncertainty Insurance Information Asymmetries Not-for-Profit Organization Technological and Institutional Change Turmoil in the Healthcare System The Pressure to Reduce Costs The Fragmentation of Healthcare Payments What Does Economics Study? Conclusion 14 Chapter 2. An Overview of the US Healthcare System Input and Output Views of Healthcare The Input View The Output View Health Outcomes Outputs of the Healthcare System Why Is How Much We Spend on Healthcare Interesting? The Shifting Pattern of Healthcare Spending Disruptive Change in the Healthcare System Rapid Technological Change Major Features of the Affordable Care Act 31 vi

3 VIII Detailed Contents The Transformation of the Health Insurance Industry Conclusion 33 Chapter 3. An Overview of the Healthcare Financing System Introduction Paying for Medical Care Indirect Spending The Uninsured What Is Insurance, and Why Is It So Prevalent? What Insurance Does Adverse Selection and Moral Hazard Medicare as an Example of Complexity The Changing Nature of Health Insurance Payment Systems Conclusion 52 Chapter 4. Describing, Evaluating, and Managing Risk Introduction Describing Potential Outcomes Evaluating Outcomes Risk Preferences Decision Analysis Sensit!vity Analysis Managing Risk Risk Sharing Diversification Conclusion 70 Chapter 5. Understanding Costs Introduction Cost Perspectives Vocabulary Factors That Influence Costs Outputs Input Costs 81

4 Detailed Contents ix Technology Efficiency Variable and Fixed Costs Conclusion 85 Chapter 6. Bending the Cost Curve The Triple Aim Reducing Costs Innovations to Reduce the Cost of Care Innovations to Reduce the Cost of Care: New Jersey Innovations to Reduce the Cost of Care: Missouri Innovations to Reduce the Cost of Care: California Conclusion 101 Chapter 7. The Demand for Healthcare Products Introduction Rationing Indirect Payments and Insurance Why Demand for Healthcare Is Complex Demand Without Insurance and Healthcare Professionals Changes in Price Factors Other Than Price Demand with Insurance Demand with Advice from Providers Conclusion 121 Chapter 8. Elasticities Introduction Elasticities Income Elasticities Price Elasticities of Demand Using Elasticities Conclusion 135

5 Detailed Contents Chapter 9. Forecasting Introduction What Is a Sales Forecast? Forecasting What Matters? Conclusion 150 Chapter 10. Supply and Demand Analysis Introduction Supply Curves Demand Curves Equilibrium Professional Advice and Imperfect Competition Demand and Supply Shifts A Shift in Demand A Shift in Supply Shortage and Surplus Analyses of Multiple Markets Conclusion 165 Chapter 11. Maximizing Profits Introduction Cutting Costs to Increase Profits Cost Reduction Through Improved Clinical Management Reengineering Maximizing Profits Return on Investment Producing to Stock or to Order Not-for-Profit Organizations Agency Problems Differences in Goals Differences in Costs Conclusion 180

6 Detailed Contents xi Chapter 12. Pricing Introduction The Economic Model of Pricing Pricing and Profits Price Discrimination Multipart Pricing Pricing and Managed Care Conclusion 197 Chapter 13. Asymmetrie Information and Incentives Asymmetrie Information Opportunism Remedies for Asymmetrie Information The Special Challenges for Healthcare Signaling Incentive Design for Providers Insurance and Incentives Limits on Incentive-Based Payments Risk Complexity Opportunism Team Production Incentive Design for Managers Conclusion 214 Chapter 14. Economic Analysis of Clinical and Managerial Interventions Introduction Cost Analysis Identifying Cost Perspective Identifying Resources and Opportun!ty Costs Direct and Indirect Costs Types of Analysis Cost-Minimization Analysis 225

7 xii Detailed Contents 14.5 Cost-Effectiveness Analysis Cost-Benefit Analysis Cost-Utility Analysis Conclusion 233 Chapter 15. Profits, Market Structure, and Market Power Introduction Rivalry Among Existing Firms Customers' Bargaining Power Entry by Potential Rivals Market Structure and Markups Markups The Impact of Market Structure on Markups Market Power and Profits Collusion Product Differentiation and Advertising Conclusion 251 Chapter 16. Government Intervention in Healthcare Markets Government Intervention in Healthcare On the Virtues of Markets Information Processing Static Resource Allocation Dynamic Resource Allocation Market Failure Externalities Public Goods Imperfect Competition Imperfect Information and Incomplete Markets Natural Monopoly Income Redistribution Remedies Assignment of Property Rights Taxes and Subsidies

8 Detailed Contents xiii Public Production Regulation Conclusion 270 Chapter 17. Regulation Introduction Market Imperfections Insurance Market Power Externalities Rational Consumer Ignorance The Interest Group Model of Regulation Limiting Competition Licensure Regulation as a Competitive Strategy Regulatory Imperfections Market Response«to Market Imperfections Tort Law and Contract Law Information Dissemination Contracts Implications for Managers Conclusion 288 Chapter 18. Behavioral Economics Introduction Inconsistent Preferences Risk Preferences Incorrect Beliefs Representativeness and the Law of Small Numbers Inconsistent Decision Making: Framing Conclusion 301 Glossary 307 Index 315 About the Author 333