German physicians' expectations of healthcare management companies: An exploratory study.

Background And Aims: Even 20 years after the introduction of managed care (MC) in Germany, many physicians are skeptical of the concept, hindering its acceptance.

Methods: Based on multivariate statistical methods this exploratory study examines how so-called management companies, that is, administrative service providers within MC contracts, can increase physicians' acceptance of MC by offering, for example, day-to-day coordination and administrative tasks.

Results: As a main empirical result, we find support for this hypothesis, that is, that certain physicians evaluate their MC participation according to its prospective administrative support.

The effects of health shocks on family status: do financial incentives encourage marriage?

This paper asks whether marriage decisions of unmarried mature couples are driven by the prospect of financial advantages for the later widowed after one partner has suffered a serious health shock. We hypothesize that, in contrast to traditional marriage models, such health shocks may induce unmarried couples to obtain economic benefits, such as survivors' pensions in particular, through marriage in advance of one partner's death. This question has not yet been studied empirically.

The socio-economic determinants of COVID-19: A spatial analysis of German county level data.

The study explores the association of socioeconomic, demographic, and health-related variables at the regional level with COVID-19 related cases and deaths in Germany during the so-called first wave through mid-June 2020. Multivariate spatial models include the 401 counties in Germany to account for regional interrelations and possible spillover effects. The case and death numbers are, for example, significantly positively associated with early cases from the beginning of the epidemic, the average age, the population density and the share of people employed in elderly care.

Can telehealth reduce health care expenditure? A lesson from German health insurance data.

This study analyzes a telemedical program for chronic heart failure in Germany with respect to economic and treatment indicators. The program entails a routine data-based preselection of the insured and specific treatment intensities for low- and high-risk patients. This study complements previous research by considering differentiated end points such as mortality and rehospitalization as well as ambulatory, outpatient, and medication costs to account for potential cost shifts.

Why do German physicians reject managed care?

Background: Approximately 20 years after the launch of managed care (MC) in Germany, the initial dynamics have turned into an MC backlash with a poor image for MC among physicians and the insured. Factors in MC contract rejection by physicians have not previously been studied systematically.

Objective: The objective of the study is to show that observed physician characteristics explain MC contract rejection in a quantitative model.

Overcoming resistance against managed care - insights from a bargaining model.

Recent healthcare reforms have sought to increase efficiency by introducing managed care (MC) while respecting consumer preferences by admitting choice between MC and conventional care. This article proposes an institutional change designed to let German consumers choose between the two settings through directing payments from the Federal Health Fund to social health insurers (SHIs) or to specialized MC organizations (MCOs). To gauge the chance of success of this reform, a game involving a SHI, a MCO, and a representative insured (RI) is analyzed.

Does managed care reduce health care expenditure? Evidence from spatial panel data.

Similar to, for example, the US, Switzerland or Great Britain the German health care sector has recently undergone a series of reforms towards managed care. These measures are intended to yield both a higher quality of care and cost containment. In our study we ask whether managed care reduces health care expenditure at the market level.