Abstract

There have been many empirical studies which focus on reimbursement systems of health care insurance. However, most of them adopt macro economic approach but micro especially in Japan. Little of published research examines the behavior of health care providers such as hospitals and doctors and service purchasers in Japan.

This paper mainly examines the effect of penetration of Managed Care and the changes of reimbursement systems since 1980s in the U.S. through systematic review of earlier researches.