From physician to consumer: the effectiveness of strategies to manage health care utilization.

Journal Article (Journal Article)

Many strategies are commonly used to influence physician behavior in managed care organizations. This review examines the effectiveness of three mechanisms to influence physician behavior: financial incentives directed at providers or patients, policies/procedures for managing care, and the selection/education of both providers and patients. The authors reach three conclusions. First, all health care systems use financial incentives, but these mechanisms are shifting away from financial incentives directed at the physician to those directed at the consumer. Second, heavily procedural strategies such as utilization review and gatekeeping show some evidence of effectiveness but are highly unpopular due to their restrictions on physician and patient choice. Third, a future system built on consumer choice is contradicted by mechanisms that rely solely on narrow networks of providers or the education of physicians. If patients become the new locus of decision making in health care, provider-focused mechanisms to influence physician behavior will not disappear but are likely to decline in importance.

Full Text

Duke Authors

Cited Authors

  • Flynn, KE; Smith, MA; Davis, MK

Published Date

  • December 2002

Published In

Volume / Issue

  • 59 / 4

Start / End Page

  • 455 - 481

PubMed ID

  • 12508705

Pubmed Central ID

  • PMC1635490

International Standard Serial Number (ISSN)

  • 1077-5587

Digital Object Identifier (DOI)

  • 10.1177/107755802237811


  • eng

Conference Location

  • United States