Selecting health care providers: “Any willing provider” vs. negotiation

Selecting Negotiation Processes with Health Care Providers

We address the question of how a third-party payer (e.g. an insurer) decides what providers to contract with. Two different mechanisms are studied and their properties compared. A first mechanism consists in the thirdparty payer setting up a bargaining procedure with both providers. The second mechanism is the so-called “any willing provider” where the third-party payer announces a contract and...

Regulatory restrictions on selective contracting: an empirical analysis of "any-willing-provider" regulations.

"Any-willing-provider" (AWP) laws compel managed care plans to accept any provider willing to accept the plan's terms and conditions, potentially undermining managed care's ability to constrain spending. However. AWP laws potentially respond to inefficient risk-selection by providers of managed care. With risk selection, observed reductions in expenditures in the managed care sector may be offs...

The Effect of Any Willing Provider and Freedom of Choice Laws on Prescription Drug Expenditures

Any Willing Provider and Freedom of Choice laws restrict the ability of managed care entities, including pharmacy benefit managers, to selectively contract with providers. The managed care entities argue this limits their ability to generate cost savings, while proponents of the laws suggest that such selective contracts limit competition, leading to an increase in aggregate costs. We examine t...

Do "any willing provider" and "freedom of choice" laws affect HMO market share?

This study examines the effects of "any willing provider" (AWP) and "freedom of choice" (FOC) laws on the market share of health maintenance organizations (HMOs) in metropolitan statistical areas over the period 1989-95. We use pooled cross-section time-series regression techniques with year and state fixed effects. HMO market share is hypothesized to be a function of state laws, market charact...

Any-willing-provider and freedom-of-choice laws: an economic assessment.