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GPs, Contracts and Inequalities

On 6th November 2017 (1-2 pm), Dr. Oddvar Kaarbøe, associate professor at the department of Health Management and Health Economics, at the University of Oslo, will give a presentation about „GPs, Contracts and Inequalities“. Afterwards Mr. Kaarbøe will be available for questions and discussions. His presentation is part of 


We analyze how the payment systems that GPs and hospital specialists face affect inequalities in treatments and referrals by presenting a model of optimal contracting between a purchaser and two providers of health services when patients can have low or high socioeconomic status (SES) and low and high severity. We find that the GP’s incentive to refer is strongest when he believes that the patient is severely ill. If the FFS the GP receives is high, only patients with high-severity signals are referred. The specialist’s incentive to treat is higher the more generous the DRG-price she faces is. If this price is high, she will treat all patients. For low prices, she will refer low-severity patients back to the GP. When the FFS is generous and the GP only refers patients when a high-severity signal is observed there is a pro-rich gradient in specialist treatment, a pro-poor gradient in GP treatment and a pro-rich gradient in benefit from treatment. Furthermore, there is a pro-rich gradient in referrals to specialists if the difference in the accuracy of the signal across socioeconomic groups is higher for high-severity patients.

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