Indirect Limit Setting: Accountability for Physician Incentives

Norman Daniels and James E. Sabin

in Setting Limits Fairly

Published in print March 2002 | ISBN: 9780195149364
Published online September 2009 | e-ISBN: 9780199865123 | DOI:
Indirect Limit Setting: Accountability for Physician Incentives

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This chapter considers how accountability for reasonableness can be applied when the responsibility for setting limits is transferred to physicians through various economic incentive or reimbursement schemes. It poses the touchstone question that physicians must answer: what are the arguments and what is the evidence that should persuade fair-minded persons that an incentive scheme is a reasonable limit-setting device? The touchstone question seeks to highlight what physicians and health plans must do to preserve public confidence in professional ethics.

Keywords: accountability; reasonableness; health care; capitation schemes; incentives

Chapter.  5985 words. 

Subjects: Public Health and Epidemiology

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