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Health care payment systems: cost and quality incentives

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CA Ma - Journal of Economics & Management Strategy, 1994 - Wiley Online Library
This paper compares the cost and quality incentive effects of cost reimbursement and
prospective payment systems in the health industry. When a provider cannot refuse patients
who require high treatment costs or discriminate patients by qualities, optimally designed ...
Cited by 312 - Related articles - Library Search - All 11 versions

Optimal health insurance and provider payment

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CTA Ma… - The American Economic Review, 1997 - JSTOR
We derive optimal insurance for patients and payment method for physicians when neither
the input decided by the patient (quantity of treatment) nor the input decided by the physician
(effort) are contractible. The equilibrium in this third-best regime may sometimes be ...
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Costs and incentives in a behavioral health carve-out

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CA Ma… - Health Affairs, 1998 - Health Affairs
A carve-out of mental health and substance abuse services initiated in 1993 by the Group
Insurance Commission (GIC) of the Commonwealth of Massachusetts resulted in changes in
the costs of those services. Those changes were related to incentives in the contract ...
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Contract Penalties, Monopolizing Strategies, and Antitrust Policy

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JF Brodley… - Stanford Law Review, 1993 - JSTOR
Two conflicting interpretations of exclusionary conduct battle for ascendancy in modem
antitrust law and industrial organization theory. The first takes a strategic view and maintains
that, given sufficient incentives and inducing circumstances, firms with market power will ...
Cited by 80 - Related articles - Get it from MIT Libraries - BL Direct - All 7 versions

Renegotiation and optimality in agency contracts

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CTA Ma - The Review of Economic Studies, 1994 - restud.oxfordjournals.org
Abstract We analyse renegotiation in a hidden action principal-agent model. Contract
renegotiation offers are made by the agent. A refinement is imposed on the principal's
beliefs: if precisely one action is optimal with respect to both the principal's and the agent's ...
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Bargaining with deadlines and imperfect player control

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CA Ma… - Econometrica: Journal of the Econometric Society, 1993 - JSTOR
Anecdotal and experimental evidence suggests that bargaining sessions subject to
deadlines often begin with cheap talk and rejected proposals. Agreements, if they are
reached at all, tend to be concluded near the deadline. We attempt to capture and explain ...
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Efficient Allocation of a

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J Glazer… - Games and Economic Behavior, 1989 - Elsevier
Abstract A planner is interested in allocating an indivisible good (a “prize”) to one of many
agents in the economy. His objective is to give the prize to the agent who values it most,
without any payments being made by the recipient. The planner, however, does not know ...
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Quality competition, welfare, and regulation

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CA Ma… - Journal of Economics, 1993 - Springer
In this paper, we study the supply of quality in imperfectly competitive markets, and explore
the role of regulation in markets where firms may use both quality and price to compete for
customers. In a model where firms first choose qualities and then prices, we find that ...
Cited by 66 - Related articles - Library Search - All 10 versions

Health insurance, moral hazard, and managed care

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CT Albert Ma… - Journal of Economics & …, 2002 - Wiley Online Library
If an illness is not contractible, then even partially insured consumers demand treatment for it
when the benefit is less than the cost, a condition known as moral hazard. Traditional health
insurance, which controls moral hazard with copayments (demand management), can ...
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Adverse selection in dynamic moral hazard

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CA Ma - The Quarterly Journal of Economics, 1991 - qje.oxfordjournals.org
Abstract This paper studies a multiperiod moral hazard problem under two assumptions:(i)
contracts are subject to renegotiations;(ii) the agent's action has long-term effects. The action
is also interpreted as a choice of characteristic or “type.” Renegotiation-proof contracts that ...
Cited by 58 - Related articles - All 12 versions

Moral hazard, insurance, and some collusion

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I Alger… - Journal of economic behavior & organization, 2003 - Elsevier
We consider a model of insurance and collusion. Efficient risk sharing requires the
consumer to get a monetary compensation in case of a loss. But this in turn implies
consumer–provider collusion incentives to submit false claims to the insurer. We assume, ...
Cited by 46 - Related articles - All 21 versions

Regulating a dominant firm: unknown demand and industry structure

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G Biglaiser… - The Rand Journal of Economics, 1995 - JSTOR
In this article, we study the optimal regulation of a dominant firm when an unregulated firm
actively competes. Generally, the existence of an active rival imposes new and binding
constraints on regulatory problems. We characterize optimal policies both when demands ...
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A signaling theory of unemployment

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C Albert Ma… - European Economic Review, 1993 - Elsevier
This paper presents a signaling explanation for unemployment. Employment at an unskilled
job may be regarded as a bad signal. Therefore good workers who are more likely to qualify
for employment at a skilled job in the future may be better off being unemployed than ...
Cited by 40 - Related articles - Library Search - All 20 versions

Moonlighting: public service and private practice

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G Biglaiser… - The RAND Journal of Economics, 2007 - Wiley Online Library
We study job incentives in moonlighting, when public-service physicians may refer patients
to their private practices. Some doctors in the public system are dedicated, and behave
sincerely, but others—the moonlighters—are utility maximizers. Allowing moonlighting ...
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Price and quality competition under adverse selection: market organization and efficiency

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G Biglaiser… - RAND Journal of economics, 2003 - JSTOR
Firms compete with prices and qualities in markets where consumers have heterogeneous
preferences and cost characteristics. Consumers demand two goods, which can be supplied
jointly or separately by firms. We consider two strategy regimes for firms: uniform price- ...
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Network incentives in managed health care

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CT Albert Ma… - Journal of Economics & …, 2002 - Wiley Online Library
This paper introduces a theory of network incentives in managed health care. Participation
in the plan's network confers an economic benefit on providers; in exchange, the plan
expects compliance with its protocols. The network sets a target for the number of ...
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Investment incentives of a regulated dominant firm

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G Biglaiser… - Journal of Regulatory Economics, 1999 - Springer
We study the investment incentives of a regulated, incumbent firm in a deregulation process.
The regulator cannot commit to a long-term regulatory policy, and investment decisions are
taken before optimal regulatory policies are imposed. We characterize the regulated ...
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Risk selection and matching in performance‐based contracting

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M Lu, C Albert Ma… - Health economics, 2003 - Wiley Online Library
Abstract This paper examines selection and matching incentives of performance-based
contracting (PBC) in a model of patient heterogeneity, provider horizontal differentiation and
asymmetric information. Treatment effectiveness is affected by the match between a ...
Cited by 19 - Related articles - BL Direct - All 13 versions

Public rationing and private cost incentives

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CA Ma - Journal of Public Economics, 2004 - Elsevier
This paper considers a public provider's strategic use of rationing in a market served by both
public and private providers. Such a 'mixed'market structure is common in many industries
such as health care, telecommunication, postal service, and public utilities. The ...
Cited by 19 - Related articles - Library Search - All 16 versions

[PDF] Optimal health care contract under physician agency

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P Choné… - forthcoming in Annales d'Économie et de Statistique, 2010 - Citeseer
Abstract We model asymmetric information arising from physician agency, and its effect on
the design of payment and health care quantity. The physician-patient coalition aims to
maximize a combination of physician profit and patient benefit. The degree of substitution ...
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Health‐Care Payment Systems: Cost and Quality Incentives—Reply

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CA Ma - Journal of Economics & Management Strategy, 1998 - Wiley Online Library
I reconsider the implementation of efficient cost and quality efforts when health-care
providers may refuse services to consumers, and introduce a mechanism that is a
combination of prospective payment and cost reimbursement. Conditions are derived for ...
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[PDF] Altruism and incentives in public and private health care

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CA Ma - … Jahnsson Foundation 50th Anniversary Symposium on …, 2004 - Citeseer
Abstract I hypothesize that physicians have diverse preferences. Some are dedicated and
provide services at high quality despite the lack of incentive or monitoring; some others
value patients' benefits. I then set up two models to consider the interaction between the ...
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[PDF] Insurance, vertical restraints, and competition

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M Gaynor… - Unpublished, Carnegie Mellon University, 1996 - heinz.cmu.edu
One of the least settled areas in modern industrial organization is the economics of vertical
restraints. 1 There are those, exemplified by the" Chicago School," who contend that there is
no possibility of anticompetitive impacts from vertical restraints (Bork, 1978; Posner, 1976; ...
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[BOOK] Asymmetric information from physician agency: optimal payment and healthcare quantity

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P Choné, CA Ma… - 2004 - bu.edu
Abstract We model asymmetric information arising from physician agency, and its effect on
the design of payment and healthcare quantity. The physician-patient coalition aims to
maximize a combination of physician profit and patient benefit. The degree of substitution ...
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[BOOK] Cost and quality incentives in health care: altruistic providers

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CA Ma… - 1998 - bu.edu
Abstract This paper compares the cost and quality incentive effects of cost reimbursement
and prospective payment systems in the health industry when providers are altruistic.
Providers' behavioral rule is governed by a desire to maximize a weighted sum of profit ...
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[PDF] Consistency in performance evaluation reports and medical records

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M Lu… - Journal of Mental Health Policy and Economics, 2002 - bu.edu
Abstract Background: In the health care market managed care has become the latest
innovation for the delivery of services. For efficient implementation, the managed care
organization relies on accurate information. So clinicians are often asked to report on ...
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Provider–client interactions and quantity of health care use

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HM Lien, CT Albert Ma… - Journal of health economics, 2004 - Elsevier
This paper considers three types of provider–client interactions that influence quantity of
health care use: rationing, effort, and persuasion. By rationing, we refer to a quantity limit set
by a provider; effort, the productive inputs supplied by a provider to increase a client's ...
Cited by 9 - Related articles - All 26 versions

[PDF] Managed care, networks and trends in hospital care for mental health and substance abuse treatment in Massachusetts: 1994-1999

[PDF] from nccu.edu.tw
E Fleming, H Lien, CTA Ma… - Journal of Mental Health …, 2003 - nccu.edu.tw
Abstract Background: Rates of inpatient care for mental health and substance abuse
treatment have been reported to fall after the introduction of managed care, but the actual
decline may be overstated. Almost all managed care impact studies are based on pre-post ...
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Paying for joint costs in health care

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C Albert Ma… - Journal of Economics & …, 1993 - Wiley Online Library
The piper analyzes a regulatory game between a phlic and a priilate payer to finance hospital
joint costs (mainly capital and technology expeerises). The p&lic payer (inspired by the federal
Medicare program) inmy both directly reimburse for joint costs ("pass-through" payments) ...
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Implementation in dynamic job transfers

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CA Ma - Economics Letters, 1988 - Elsevier
Abstract The implementation problem in a dynamic incentive contract with job transfers is
studied. We find that in the job transfers contract, there are multiple equilibria, in some of
which the agents can lie. We construct a mechanism to uniquely implement the principal's ...
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Service motives and profit incentives among physicians

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G Godager, T Iversen… - … journal of health care finance and …, 2009 - Springer
Abstract We model physicians as health care professionals who care about their services
and monetary rewards. These preferences are heterogeneous. Different physicians trade off
the monetary and service motives differently, and therefore respond differently to incentive ...
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Progress and compliance in alcohol abuse treatment

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HM Lien, M Lu, CT Albert Ma… - Journal of health economics, 2010 - Elsevier
Improving patient compliance with physicians' treatment or prescription recommendations is
an important goal in medical practice. We examine the relationship between treatment
progress and patient compliance. We hypothesize that patients balance expected benefits ...
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[CITATION] Public Rationing and Private Sector Selection

S Grassi… - 2008 - Boston University working paper
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Health insurance, cost expectations, and adverse job turnover

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RP Ellis… - Health Economics, 2011 - Wiley Online Library
Because less healthy employees value health insurance more than the healthy ones, when
health insurance is newly offered job turnover rates for healthier employees decline less
than turnover rates for the less healthy. We call this adverse job turnover, and it implies ...
Cited by 3 - Related articles - All 11 versions

Public sector rationing and private sector selection

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S Grassi… - Journal of Public Economic Theory, 2012 - Wiley Online Library
We study the interaction between nonprice public rationing and prices in the private market.
Under a limited budget, the public supplier uses a rationing policy. A private firm may supply
the good to those consumers who are rationed by the public system. Consumers have ...
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[CITATION] Regulation, Quality Competition, and Price in the Hospital Industry

CA Ma… - Working Papers, 1991 - econpapers.repec.org
... EconPapers has moved to http://EconPapers.repec.org! Please update your
bookmarks. Regulation, Quality Competition, and Price in the Hospital
Industry. Ching-to Albert Ma () and James F. Burgess. ...
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[PDF] Rationing poor consumers to reduce prices

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S Grassi… - Boston University-Department of Economics-Working …, 2008 - Citeseer
Abstract We study how rationing in the public sector influences prices in the private sector. A
private firm uses consumers' cost information for cream-skimming. Only rationed consumers
consider purchasing from the private firm. Rich consumers are more willing to pay for an ...
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[CITATION] kOptimal health insurance and provider paymentl

MC Albert… - American Economic Review, 1997
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13. Monitoring and enforcement in federal alcohol and drug abuse block grants

CA Ma, TG McGuire… - The economics of health care in …, 2002 - books.google.com
Block grants to fund state mental health and substance abuse services started with
President Reagan's omnibus Budget Reconciliation Act of 1981. In 1982, the Alcohol, Drug
Abuse and Mental Health (ADAMH) block grants replaced ten mental health and ...
Cited by 2 - Related articles - All 2 versions

[CITATION] Regulating a Dominant Firm: Quality, Private Informatio, and Industry Structure

G Biglaiser… - Working Papers, 1993 - econpapers.repec.org
Related works: Working Paper: Regulating a Dominant Firm: Quality, Private Information, and
Industry Structure (1993) This item may be available elsewhere in EconPapers: Search for items
with the same title. ... This site is part of RePEc and all the data displayed here is part of ...
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[PDF] IMMIGRANTS'ACCULTURATION AND CHANGES IN BODY MASS INDEX

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T Iversen, CA Ma… - 2010 - sws1.bu.edu
Tor Iversen Department of Health Management and Health Economics Institute of Health and
Society University of Oslo PO Box 1089 Blindern NO-0317 Oslo, Norway
tor.iversen@medisin.uio.no ... Ching-to Albert Ma Department of Economics Boston ...
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Health Insurance, Cost Expectations, and Adverse Job Turnover

RP Ellis… - Boston University-Department of Economics- …, 2007 - ideas.repec.org
In our theoretical model some firms do not offer health insurance to their employees
because of large between-firm heterogeneity in expected employee health care costs.
Because job turnover rates for healthier employees reduce by less than those for sicker ...
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[PDF] Subsidy Design and asymmetric information: wealth versus benefits

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S Grassi… - 2008 - Citeseer
Abstract A government or public organization would like to subsidize an indivisible good.
Consumers' valuations of the good vary according to their wealth and benefits from the
good. Education, medical care, and housing are common examples. A subsidy scheme ...
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Optimal Health Care Contract under Physician Agency

CA Ma - 2010 - Citeseer
Abstract We model asymmetric information arising from physician agency, and its effect on
the design of payment and health care quantity. The physician aims to maximize a
combination of physician profit and patient benefit. The degree of substitution between ...
Cited by 1 - Related articles - Cached - All 3 versions

Risk Selection and Matching in Performance-Based Contracting

M Lu, CA Ma… - Working Papers, 2000 - en.scientificcommons.org
Abstract This paper examines selection and matching incentives of Performance-Based
Contracting (PBC) in a model of patient heterogeneity, provider horizontal differentiation and
asymmetric information. Treatment effectiveness is affected by the match between a ...
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Optimal public rationing and price response

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S Grassi… - Journal of Health Economics, 2011 - Elsevier
ABSTRACT: We study optimal public health care rationing and private sector price
responses. Consumers differ in their wealth and illness severity (defined as treatment cost).
Due to a limited budget, some consumers must be rationed. Rationed consumers may ...
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[CITATION] Health Care Economics and Policy: An Introduction

CA Ma - The BE Journal of Economic Analysis & Policy, 2008 - ideas.repec.org
If you experience problems downloading a file, check if you have the proper application to
view it first. Information about this may be contained in the File-Format links below. In case of
further problems read the IDEAS help page. Note that these files are not on the IDEAS site ...
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Waiting lists and patient selection

S GRASSI… - Journal of Public Economic Theory, 2012 - ingentaconnect.com
We study the interaction between nonprice public rationing and prices in the private market.
Under a limited budget, the public supplier uses a rationing policy. A private firm may supply
the good to those consumers who are rationed by the public system. Consumers have ...
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[BOOK] Experience Benefits and Firm Organization

[PDF] from u-cergy.fr
I Alger, CA Ma, R Renault… - 2009 - u-cergy.fr
Abstract A principal requires a manager for production. He can use an internal manager, or
contracts with an external manger. In each case, the manager obtains experience benefits
from production. When the principal uses an internal manager, both parties share cost ...
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Behavioral Health Expenditures and State Organizational Structure

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E Fleming, C Albert Ma… - … and Policy in Mental Health and …, 2000 - Springer
The authors present a study on expenditures by state mental health, substance abuse, and
developmental disability agencies in the United States for the period between 1981 and
1993. The relationship between agency spending and organizational structure of state ...
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Market conditions and general practitioners' referrals

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T Iversen… - International journal of health care finance and …, 2011 - Springer
Abstract We study how market conditions influence referrals of patients by general
practitioners (GPs). We set up a model of GP referral for the Norwegian health care system,
where a GP receives capitation payment based on the number of patients in his practice, ...
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[CITATION] Capacity Constraint and Monopoly Regulation under Asymmetric Information

CA Ma… - Working Papers, 1996 - econpapers.repec.org
... EconPapers has moved to http://EconPapers.repec.org! Please update your
bookmarks. Capacity Constraint and Monopoly Regulation under Asymmetric
Information. Ching-to Albert Ma () and Clemencia Torres (). ...
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[CITATION] Noncontractible Inputs and Health Insurance-payment Policies

CA Ma, TG McGuire… - 1994 - Industry Studies Program, …
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[CITATION] Incomplete, draft; not for circulation, citation, or quotation.

G Godager, T Iversen… - 2006
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The Economics of Consumer‐Directed Health Care

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CTA Ma - Financing Health Care, 2007 - Wiley Online Library
Abstract This chapter presents a model of consumer-directed health care, high-deductible
insurance plans. Insurance companies in a competitive market offer such plans; higher
deductibles result in lower premiums. Such changes affect consumers' decisions on ...
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[PDF] Managed Care and Trends in Hospital Care for Mental Health and Substance Abuse Treatment in Massachusetts: 1994-1999

[PDF] from bu.edu
E Fleming, H Lien, CTA Ma… - 2002 - bu.edu
Abstract Background: Rates of inpatient care for mental health and substance abuse
treatment have been reported to fall after the introduction of managed care, but the actual
decline may be overstated. Almost all managed care impact studies are based on pre-post ...
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[CITATION] Mental Health Carve-Outs: The Authors Respond

[PDF] from healthaffairs.org
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CTA Ma… - Health Affairs, 1998 - Health Affairs
To the Editor: By emphasizing only cost, Michael Jellinek's letter both distorts the focus of our
paper and places a negative valence on our findings. This is an unfortunate politicization of
some complex issues. Specifically, we address benefit enhancement, access, utilization, ...

[CITATION] The Industrial Organization of Health Care III

AM Ching-To - 1999 - MIT Press
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[PDF] Health Insurance, Treatment Plan, and Delegation to Altruistic Physician

[PDF] from unil.ch
T Liu… - 2011 - hec.unil.ch
Abstract We study delegating a consumer's treatment plan decisions to an altruistic
physician. The physician's degree of altruism is his private information. The consumer's
illness severity will be learned by the physician, and also become his private information. ...
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[PDF] Information, Incentive Alignment, and Firm Organization

[PDF] from webmeets.com
I Alger, CA Ma… - 2007 - webmeets.com
Abstract A firm chooses between in-house production and outsourcing for a task supervised
by a manager. The manager may gather certifiable information about production costs and
acquires on-the-job experience that will yield additional surplus in her future career. ...
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[PDF] Surplus and Information in a Firm's Make-or-Buy Decision

[PDF] from economics.ca
I Alger, CA Ma… - 2008 - economics.ca
Abstract What determines firm boundaries? We propose a hitherto unexplored trade-off
between making and buying for a firm. In our model a firm needs a manager to oversee
production: the firm chooses between hiring a manager as an employee, and contracting ...
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[CITATION] Using Insight from Game Theory: Penalty Contracts and Monopolizing Strategies

Full text - MIT Libraries
JF Brodley… - Antitrust, 1994

[PDF] Renegotiation and Optimality 1n Agency Contracts

[PDF] from bu.edu
CTOA MA - 1994 - sws1.bu.edu
We analyse renegotiation in a hidden action principal-agent model. Contract renegotiation
offers are made by the agent. A refinement is imposed on the principal's beliefs: if precisely
one action is optimal with respect to both the principal's and the agent's contracts, the ...
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[PDF] Public Report, Price, and Quality

[PDF] from uni-muenchen.de
CA Ma… - 2011 - hans-moeller-seminar.vwl.uni- …
Abstract A monopolist produces a good with two qualities. All consumers have the same
valuation of the first quality, but their valuations of the second vary, and are their private
information. Qualities cannot be directly observed by consumers. A public agency can ...
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[PDF] Information Disclosure and the Equivalence of Prospective Payment and Cost Reimbursement

[PDF] from unisa.it
CA Ma… - 2012 - unisa.it
Abstract A health care provider chooses medical service quality and cost-reduction effort.
Both choices are noncontractible. An insurer observes both quality and cost effort, and may
credibly disclose them to consumers. In prospective payment, the insurer fully discloses ...
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Cost and Quantity Invcentives in Health Care: Altruistic Providers

CA Ma - Working Papers, 1998 - econpapers.repec.org
This paper compares the cost and quality incentive effects of cost reimbursement and
prospective payment systems in the health industru when providers are altuistic. Provider's
behavioral rule is governed by a desire to maximize a weighted sum of profit and ...
Cached - Get it from MIT Libraries - All 2 versions

Health Insurance, Treatment Plan, and Delegation to Altruistic Physician

CA Ma… - 2010 - papers.ssrn.com
Abstract: We study delegating a consumer's treatment plan decisions to an altruistic
physician. The physician's degree of altruism is his private information. The consumer's
illness severity will be learned by the physician, and also become his private information. ...
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[CITATION] Noncontractible Inputs and Health Insurance-Payment Systems

CA Ma… - Working Papers, 1994 - econpapers.repec.org
... EconPapers has moved to http://EconPapers.repec.org! Please update your
bookmarks. Noncontractible Inputs and Health Insurance-Payment Systems.
Ching-to Albert Ma () and Thomas G. McGuire (). ...
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[CITATION] Moral ÀaÞard, Insurance, and Some Collusion

I Alger…
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[CITATION] The Industrial Organization of Health Care III: Introduction

CA Ma…

[PDF] A Journey for Your Beautiful Mind: Economics Graduate Study and Research

[PDF] from bibsys.no
CA Ma - Boston University-Department of Economics-Working …, 2007 - brage.bibsys.no
You must be very excited, ready to start your Ph. D. program here in Bergen. To many of you
this will be an important milestone. It should be. Undertaking a Ph. D. study is not a trivial
matter, and I hope that you do take this seriously.
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[CITATION] The Industrial Organization of Health Care V

TC Buchmueller… - 2005 - MIT Press
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Subsidy design: wealth versus benefits

[PDF] from bu.edu
Full text - MIT Libraries
S Grassi… - Journal of Economics, 2010 - Springer
Abstract A government would like to subsidize an indivisible good. Consumers' valuations of
the good vary according to their wealth and benefits from the good. A subsidy scheme may
be based on consumers' wealth or benefit information. We translate a wealth-based policy ...
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[CITATION] The industrial organization of health care: special issue

TG MacGuire, MH Riordan… - Journal of economics, 1994
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[CITATION] The Industrial Organization of Health Care II

CA Ma… - 1997 - MIT Press
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