@article{c8114904e48349f782e231d069d841ae,
title = "Nonprice rivalry among health insurers and coverage of new technologies",
abstract = "This paper develops a multiple-period theoretical model of health maintenance organization (HMO) coverage of medical procedures as a function of HMO competition and a market's predisposition toward managed care. Previous empirical results regarding one laser procedure were not predicted by a single-period model. The new model predicts that more favorable predisposition toward managed care is positively associated with coverage of procedures for which coverage is discretionary. The empirical analysis in this paper focuses on 13 additional laser procedures. The new empirical findings are different from the previous findings and are more consistent with the hypotheses generated by the new theoretical model.",
author = "Frick, {Kevin D.} and Powe, {Neil R.}",
note = "Funding Information: In today's health insurance market, an important element of nonprice competition which affects the actuarially fair premium and individuals' willingness to pay an excess premium is the HMO's ability to limit utilization, particularly for expensive procedures. HMOs can limit the utilization of specific procedures in at least four distinct ways: 1) by not covering the procedure; 2) by structuring reimbursement of covered procedures to give physicians financial incentives to not use available costly procedures; 3) by structuring reimbursement of covered procedures to discourage the adoption of specific technologies by hospitals and physicians' offices; and 4) by discouraging research into new technologies. Medical research may be discouraged either because researchers do not anticipate that the technology wilt be reimbursed or because the costs of research are not reimbursed. Health *Johns Hopkins University--U.S.A. The data were obtainedu nder a grant from the Office of Technology Assessment (HMO Laser Procedure Coverage) and the University of Michigan Rackham Pre-doctoral Fellowship (InterStudy). The authors would like to thank an anonymousr eviewera nd participants at a session sponsored by the International Atlantic Economic Society at the 1998 Allied Social Science Association meetings, Chicago, IL, for their helpful comments. Any remaininge rrors belong to the authors.",
year = "2000",
doi = "10.1007/BF02298397",
language = "English (US)",
volume = "28",
pages = "450--462",
journal = "Atlantic Economic Journal",
issn = "0197-4254",
publisher = "Springer Netherlands",
number = "4",
}