International Journal of Health Care Finance and Economics (Int J Health Care Finance Econ )

Publisher: Springer Verlag

Description

The demand for health care will surely continue to increase in the future. How to finance the cost of that care will remain on the policy agenda. In the public domain expenditures on health services will always compete with other uses of tax funds such as defence and education; the debate about the magnitude of the government's involvement in health care is here to stay. In the private sector payment for health services not covered by government ñ in the form of insurance premiums and direct payment ñ competes with other consumption spending and saving. The problem of how to finance health care in either sector must be addressed with general tax financing social insurance and private financing as alternatives. Knowledge of why people choose alternative arrangements either in markets or through the political process is one key to understanding the problem. In addition choices with regard to the financing of health care are also crucial because they determine methods of payment for health care and payment methods in turn influence the supply decisions of health care providers. This creates an important connection between the financing of a health care system and its performance. The problems of financing and the links among financing payment and performance will constitute the core topics of International Journal of Health Care Finance and Economics . The primary audience for this journal will be health economists and health services researchers. In addition readership is certain to include health care providers and managers and their trade associations who need to know about the financial pressures facing insurers and governments with consequences for regulation and mandates. Insurers and employee benefit organizations also want to learn more about provider responses to incentives and regulations. Representatives of social security and government wish to find out about and compare international experiences with regard to the level and distribution of the tax burden associated with reforms. The editors of International Journal of Health Care Finance and Economics encourage submissions that analyze the behavior and interaction of the actors in health care viz. consumers providers insurers and governments under the influence of health care finance and regulation. Preference will be given to contributions that combine theoretical with empirical work evaluate conflicting findings or compare experiences between countries and jurisdictions. The composition of the editorial board is designed to avoid editorial bias. Every effort will be made to reach a first decision about a submission within one hundred days.

  • Impact factor
    0.49
  • 5-year impact
    0.00
  • Cited half-life
    5.90
  • Immediacy index
    0.20
  • Eigenfactor
    0.00
  • Article influence
    0.00
  • Website
    International Journal of Health Care Finance and Economics website
  • Other titles
    International journal of health care finance and economics (Online)
  • ISSN
    1389-6563
  • OCLC
    48389052
  • Material type
    Document, Periodical, Internet resource
  • Document type
    Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details

Springer Verlag

  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author can archive a post-print version
  • Conditions
    • Authors own final version only can be archived
    • Publisher's version/PDF cannot be used
    • On author's website or institutional repository
    • On funders designated website/repository after 12 months at the funders request or as a result of legal obligation
    • Published source must be acknowledged
    • Must link to publisher version
    • Set phrase to accompany link to published version (The original publication is available at www.springerlink.com)
    • Articles in some journals can be made Open Access on payment of additional charge
  • Classification
    ​ green

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Many developing countries have introduced social health insurance programs to help address two of the United Nations' millennium development goals-reducing infant mortality and improving maternal health outcomes. By making modern health care more accessible and affordable, policymakers hope that more women will seek prenatal care and thereby improve health outcomes. This paper studies how Ghana's social health insurance program affects prenatal care use and out-of-pocket expenditures, using the two-part model to model prenatal care expenditures. We test whether Ghana's social health insurance improved prenatal care use, reduced out-of-pocket expenditures, and increased the number of prenatal care visits. District-level differences in the timing of implementation provide exogenous variation in access to health insurance, and therefore strong identification. Those with access to social health insurance have a higher probability of receiving care, a higher number of prenatal care visits, and lower out-of-pocket expenditures conditional on spending on care.
    International Journal of Health Care Finance and Economics 08/2014;
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    ABSTRACT: This paper constructs a model of saving for retired single people that includes heterogeneity in medical expenses and life expectancies, and bequest motives. We estimate the model using Assets and Health Dynamics of the Oldest Old data and the method of simulated moments. Out-of-pocket medical expenses rise quickly with age and permanent income. The risk of living long and requiring expensive medical care is a key driver of saving for many higher-income elderly. Social insurance programs such as Medicaid rationalize the low asset holdings of the poorest but also benefit the rich by insuring them against high medical expenses at the ends of their lives. (c) 2010 by The University of Chicago. All rights reserved..
    International Journal of Health Care Finance and Economics 01/2009;
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    ABSTRACT: This paper elaborates on the optimal negligence standard in a world where physicians choose their level of care subject to erroneous court judgements and to the degree of supply-side cost sharing. Uncertain liability in malpractice lawsuits leads physicians to provide excessive and insufficient care, which results in a loss of social welfare. The standard that maximizes welfare depends on the cost share: Under traditional, close to full cost reimbursement it is lower than the first-best level of care, while under substantial supply-side cost sharing it increases and may even exceed the first best.
    International Journal of Health Care Finance and Economics 07/2008; 8(2):73-85.
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    ABSTRACT: Previous analyses of families with high health care expenditure burdens have ignored the potentially mitigating effects of tax subsidies. This analysis uses data from the Medical Expenditure Panel Survey (MEPS) to fill this gap. A range of health expenditure burden measures are computed, with and without tax subsidies, showing the impact that tax subsidies have on both the prevalence and magnitude of high health care spending burdens among the nonelderly.
    International Journal of Health Care Finance and Economics 07/2008; 8(3):209-23.
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    ABSTRACT: When choosing from a menu of treatment alternatives, the optimal treatment depends on the objective function and the assumptions of the model. The classical decision rule of cost-effectiveness analysis may be formulated via two different objective functions: (i) maximising health outcomes subject to the budget constraint or (ii) maximising the net benefit of the intervention with the budget being determined ex post. We suggest a more general objective function of (iii) maximising return on investment from available resources with consideration of health and non-health investments. The return on investment approach allows to adjust the analysis for the benefits forgone by alternative non-health investments from a societal or subsocietal perspective. We show that in the presence of positive returns on non-health investments the decision-maker's willingness to pay per unit of effect for a treatment program needs to be higher than its incremental cost-effectiveness ratio to be considered cost-effective.
    International Journal of Health Care Finance and Economics 07/2008; 8(2):113-21.
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    ABSTRACT: For an individual insurance firm offering supplementary private health insurance, a model is developed to decompose market performance in terms of insurer profits. For the individual contract, the model specifies the conditions under which adverse selection, cream skimming, and moral hazard occur, shows the impact of information on contracting, and the profit contribution. Contracts are determined by comparing willingness to pay for insurance with the individual's risk position, and information on both sides of the market. Finally, performance is aggregated up to the total market. The model provides a framework to explain the attractiveness of supplementary markets to insurers.
    International Journal of Health Care Finance and Economics 07/2008; 8(3):193-208.
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    ABSTRACT: In Japan, the use of percutaneous transluminal coronary angioplasty (PTCA) for the treatment of acute myocardial infarction (AMI) is extraordinarily frequent, resulting in large medical expenditure. Using chart-based data and exploiting regional variations, we explore what factors explain the frequent use of PTCA, employing propensity score matching to estimate the average treatment effects on hospital expenditure and hospital days. We find that the probability of receiving PTCA is affected by the density of medical resources in a region. Moreover, expenditure is higher for treated patients while there are no significant differences in hospitalization days, implying that the frequent use of PTCA is economically motivated.
    International Journal of Health Care Finance and Economics 07/2008; 8(2):123-44.
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    ABSTRACT: The Institute for Clinical Systems Improvement recommends reducing the number of prenatal care visits recommended for low-risk women, citing evidence from a randomized clinical trial indicating that the reduction would not adversely impact infant health. We investigate the implicit hypothesis that prenatal care resources are not distributed efficiently across high-risk and low-risk women. Using clinic-reported prenatal care and an inclusive measure of infant health, we report evidence indicating inefficient resource utilization: prenatal care only boosts infant health when mothers have specific pre-existing diagnoses, but women with high potential to benefit from care do not obtain more care than other women.
    International Journal of Health Care Finance and Economics 06/2008; 8(3):163-79.
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    ABSTRACT: It is a commonly held belief that full billed charges for hospital services, when submitted to uninsured patients, constitute such an extraordinary payment burden that hospitals' attempts to collect full payment are irrational. We examine that proposition with data on the joint distribution of hospital charges and uninsured incomes, guided by prevailing standards on the concept of ability-to-pay. We find that there is in fact a substantial intersection of charges and incomes in which full payment from the uninsured, or at least substantial partial payment, is a reasonable commercial expectation. When we quantify the estimated extent of charge collectability, we conclude that there is empirical support for current hospital collection practices.
    International Journal of Health Care Finance and Economics 04/2008; 8(1):53-72.
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    ABSTRACT: Not-for-profit hospitals rely heavily on tax-exempt debt. Investor confidence in such instruments was shaken by the 1998 bankruptcy of the Allegheny Health and Education Research Foundation (AHERF), which was the largest U.S. not-for-profit failure up to that date and whose default was accompanied by claims of accounting irregularities. Such shocks can result in contagion whereby all hospitals are viewed as riskier. We test for the significance and duration of resulting contagion using an industry-specific model of interest cost determinants. Empirical tests indicate that contagion does occur, resulting in higher interest on new debt issues from other hospitals.
    International Journal of Health Care Finance and Economics 04/2008; 8(1):27-51.
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    ABSTRACT: This paper uses metropolitan data to test empirically if health insurers possess monopsony or monopoly-busting power on the buyer-side of the hospital services market. According to theory, monopsony power is indicated by a fall in output, whereas, monopoly-busting power is shown by an increase in output when buyer concentration rises. The empirical results provide evidence that greater health insurer buyer concentration is not associated with monopsony power. Instead, some evidence is found to suggest that higher health insurer concentration translates into increased monopoly-busting power. That is, metropolitan hospitals offer increased services when the buyer-side of the hospitals services market is more highly concentrated.
    International Journal of Health Care Finance and Economics 04/2008; 8(1):1-11.
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    ABSTRACT: The objective of this paper is to describe the market structure of health plans (HPs) and physician organizations (POs) in California, a state with high levels of managed care penetration and selective contracting. First we calculate Herfindahl-Hirschman (HHI) concentration indices for HPs and POs in 42 California counties. We then estimate a multivariable regression model to examine the relationship between concentration measures and the prices paid by HPs to POs. Price data is from Medstat MarketScan databases. The findings show that any California counties exhibit what the Department of Justice would consider high HHI concentration measures, in excess of 1,800. More than three quarters of California counties exhibit HP concentration indices over 1,800, and 83% of counties have PO concentration levels in excess of 1,800. Half of the study counties exhibited PO concentration levels in excess of 3,600, compared to only 24% for plans. Multivariate price models suggest that PO concentration is associated with higher physician prices (p < or = 0.05), whereas HP concentration does not appear to be significantly associated with higher outpatient commercial payer prices.
    International Journal of Health Care Finance and Economics 03/2008; 8(1):13-26.
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    ABSTRACT: In the United States, end-stage renal disease (ESRD) patients are primarily insured by the publicly funded Medicare program. Compared to other countries in the International Study of Health Care Organization and Financing (ISHCOF), the United States has the highest health care expenditures for the general population and among ESRD patients. However, because the Medicare program is more influential in the market for ESRD-related services than for other medical services, ESRD price controls have been relatively stringent. Nonetheless, ESRD costs have grown substantially through increases in prevalence and use of ancillary services. Treatment costs are also controlled by the relatively high rate of transplantation. Proposed reforms include bundling more services into a prospective payment system, developing case-mix adjustments, and financially rewarding providers for quality.
    International Journal of Health Care Finance and Economics 01/2008; 7(4):301-18.
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    ABSTRACT: While the prevalence of end-stage renal disease (ESRD) in Spain is high, the incidence in comparison to the United States and Japan is low. Spain's rate of deceased organ donation is the highest in the world, and its renal transplant incidence rate is also relatively high. In addition, ESRD care represents a large portion of the overall health care budget. Quality of care in the National Health Service is not determined by competition or performance rewards; instead, several health agencies and scientific societies monitor it. Nevertheless, nephrologists with low salaries have relatively few professional and economic incentives to improve quality.
    International Journal of Health Care Finance and Economics 01/2008; 7(4):253-67.

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