Resource-based relative value schedule as an instrument for price collusion in the health care industry: a collusive monopsony case.
In this study I describe the mechanism that facilitates tacit collusion and price coordination, present evidence that firms use the Resource Based Relative Value Scale (RBRVS) to coordinate fees, and describe how monopsonistic behavior may be the result of such actions. My findings reveal that private insurance companies have adjusted downward the reimbursement for Pap smears. This adjustment has been guided by the government's usage of RBRVS to calculate reimbursements. I conclude that the use of RBRVS as a prospective payment is in essence a price control mechanism that poses the problem of how to ensure that real prices are not lowered through the expedient of increasing profits.
Sevilla
Dennis L
DL
School of Politics and Economics, Claremont Graduate University, Claremont CA, USA.
D003299:Cooperative Behavior; D005260:Female; D019981:Health Care Sector; D006801:Humans; D008329:Managed Care Programs; D018803:Models, Economic; D065006:Papanicolaou Test; D011907:Rate Setting and Review; D012051:Reimbursement Mechanisms / Q000458:organization & administration / Q000706:statistics & numerical data; D015895:Relative Value Scales; D014481:United States; D014626:Vaginal Smears / Q000191:economics