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Competitive bidding for Medicare services

T J Hoerger1, T M Waters

  • 1Department of Economics and Business Administration, Vanderbilt University, Nashville, TN 37235.

Medical Care
|October 1, 1993
PubMed
Summary
This summary is machine-generated.

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Medicare fee schedules can be improved with competitive bidding, creating two stages of provider competition and influencing service quality. The bidding design is crucial for optimal outcomes in healthcare services.

Area of Science:

  • Health Economics
  • Healthcare Policy
  • Market Competition Analysis

Background:

  • Implementing prospective Medicare fee schedules requires accurate pricing reflecting market forces.
  • Competitive bidding is a proven procurement method for non-health services.

Purpose of the Study:

  • To evaluate how provider behavior is affected by Medicare using competitive bidding for fee schedules.
  • To analyze the impact of bidding mechanism design on competition and quality.

Main Methods:

  • Economic modeling of provider behavior under competitive bidding.
  • Analysis of a two-stage competition model (bidding and post-bidding).
  • Examination of bidding mechanism design elements and their effects.

Main Results:

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  • Competitive bidding creates a two-stage competition: bid submission and post-win marketing.
  • Bidding mechanism design, including penalties, significantly influences provider strategies.
  • Quality may decline with exclusive winners but can be maintained with multiple winners.

Conclusions:

  • Competitive bidding can reshape healthcare markets and provider behavior.
  • Careful design of bidding mechanisms is essential for achieving desired outcomes.
  • Criteria for suitability of Medicare services for competitive bidding are identified.