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タイトル: Incentive for gatekeepers and their demand inducement: An empirical analysis of care managers in the Japanese Long-Term Care Insurance
著者: Sugawara, Shinya
Nakamura, Jiro
キーワード: Elderly care
Gatekeepers
Incentive
Supplier-induced demand
Japanese Long-Term Care Insurance program
Care managers
JEL classi cation codes: I18; I11; J13
発行日: 2014年1月
出版者: 日本経済国際共同センター
抄録: This study analyzes incentives and supplier-induced demand of care managers, middlemen between consumers and service providers in the Japanese social insurance program for long-term care. Care managers can be considered as pure gatekeepers in that their function is limited to referral to specialists and they themselves do not provide care. Rewards for care managers are rendered by capitation, which is considered as a cost-effective payment mechanism for insurers. However, many care managers actually work for firms that also operate service provision sectors. The service providers are rewarded by the fee-for-service payment and have motivation to induce excess consumer demand. Thus, the violation of neutrality of care managers might yield an financial burden on social insurance. In this study, we empirically analyze the behavior of care managers by checking whether they cause supplier-induced demand. Our estimation results detect the existence of care manager-induced demand for care managers who work for firms that jointly operate in service provision sectors; however, those who operate only care management do not induce demand. Based on the estimation results, we conduct a quantitative analysis and show that the care manager-induced produces a considerable financial burden on social insurance.
URI: http://hdl.handle.net/2261/55831
その他の識別子: CIRJE-F-916
出現カテゴリ:061 ディスカッションペーパー
Discussion Paper F series (in English)

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