Please use this identifier to cite or link to this item: https://hdl.handle.net/10419/76572 
Year of Publication: 
2003
Series/Report no.: 
CESifo Working Paper No. 1063
Publisher: 
Center for Economic Studies and ifo Institute (CESifo), Munich
Abstract: 
Incentive contracts for gatekeepers who control patient access to specialist medical services provide too weak incentives to investigate cost further when expected cost of treatment is greater than benefit. Making gatekeepers residual claimants with a fixed fee from which treat-ment costs must be met (as with full insurers who are themselves gatekeepers) provides too strong incentives when expected cost is less than benefit. Giving patients the choice between a gatekeeper with an incentive contract and one without is unstable. With one scenario, pa- tients always prefer the latter. With another, patients have incentives to acquire information that makes incentive contracts ineffective.
Subjects: 
gatekeepers
patient referrals
general practitioners
fundholding
medical insurance
incentive contracts
Document Type: 
Working Paper
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