The Impact of Financial Incentives on Physician Behavior

Paper Summary:

This paper takes a look at the problem of overbilling by physicians and how managed care organizations aim to lower the cost of providing health care to the general public. Explaining the origins of managed care the paper describes the adverse effects that this well-meaning system has on patients - physicians are now spending less time with their patients not only due to confusing financial incentives, but also because they feel that care quality was being compromised with the now limited number of tests and referrals that can be made. A literature review that explores the ethical issues of cost-cutting based behavior of physicians,is included in the paper to provide insight on how financial incentives affect physician behavior.

Outline:
Chapter One - Introduction
Background of the Concern
Statement of the Problem
Conflicts and Capitation
Purpose of the Study
Delimitations of the Study
Limitations of the Study
Assumptions
Hypothesis
Chapter Two - Literature Review
Care Quality Components
Payment Methods
Physician Behavior
Kaiser Family Study Theoretical Implications
Financial Incentives
Theoretical Implications
Ethics
Project Objectives
Methodology
Population
Importance of Study
Data Analysis and Findings
Analysis
Conclusion

From the Paper:

"In order to understand the current problem faced by physicians regarding Managed Care Organizations (MCOs), it is important to take a look into the background of the concern. Before managed care came about, indemnity plans and fee-for-service plans were dominant in the area of physician reimbursement. Payment for the services rendered by a physician was made regardless of the diagnosis made or the number of tests run. Individuals expected to pay the physician when their appointment was over, or they expected to make their co-payment and let their standard insurance company pick up the rest of the bill."

Sample of Sources Used:

• Armour, B.S., Pitts, M.M., Maclean, R., Cangialose, C., Kishel, M., Imai, H. & Etchason, J. (2001). The effect of explicit financial incentives on physician behavior. Archives in Internal Medicine, 161, 1261-1266.
• Berwick, M. (1996). Payment by capitation and the quality of care. JAMA, 335, 1127-1230.
• Campbell, S.M., Koland, M.O. & Buetow, S.A. (2004). Defining quality of care. Social Science and Medicine, 51, 1611-25.
• Devettere, R.J. (2000). Practical decision making in healthcare ethics: Cases and concepts. Washington DC: Georgetown University Press.
• Eastman, J.K., Eastman, K.L. & Tolson, M.A. (2000). Leaving an unethical managed care plan: An exploratory look at doctors' intentions. Benefits Quarterly, 2nd quarter, 33-44.

More papers on The Impact of Financial Incentives on Physician Behavior:

• Research Paper # 29294 : "Financial Incentives and Physician Behavior"
• Research Paper # 137158 : "The Impact of Birth Order on Human Behaviour"
• Essay # 143774 : "The Impact of Chronic Illness on Quality of Life "

APA Citation:

MLA Citation: