A Brief Introduction to Game Theory and its Potential Implications for the Economics of Orthotics & Prosthetics.

Goeran Fiedler,Armin Schikorra

doi:10.33137/cpoj.v4i2.36661

Abstract

The economic viability of Orthotics & Prosthetics (O&P) service provision is an important concern for policy makers, patients, and practitioners. Against the background of limited funds that can be distributed for healthcare expenses overall, it is critical to identify the most cost-effective treatment options within and across disciplines, including surgical and pharmacological interventions. When those decisions are being negotiated, whether in the context of an individual case in the clinic or of general payer policies that allocate spending budgets, the O&P discipline is often perceived to be at a disadvantage due to its relatively young age, underdeveloped evidence base, and small economic clout as compared to other fields. Such asymmetrical negotiations have been the subject of economic theories and mathematical models, such as the "Game theory", work on which has been awarded with several Nobel Prizes and other recognitions across the years. In this paper, we are introducing core concepts of this theory and discuss how they may be applied in negotiations on treatment approaches and reimbursement schedules with the goal to improve outcomes for the O&P profession.

Highlights

The costs of health care provision in the United States is estimated to exceed $4 trillion (T) in the year 2020.1 More than half of this amount is expended for hospital care ($1.3T) and physician and clinical services ($794B)
The economic viability of Orthotics & Prosthetics (O&P) service provision is an important concern for policy makers, patients, and practitioners
Against the background of limited funds that can be distributed for healthcare expenses overall, it is critical to identify the most cost-effective treatment options within and across disciplines, including surgical and pharmacological interventions. When those decisions are being negotiated, whether in the context of an individual case in the clinic or of general payer policies that allocate spending budgets, the O&P discipline is often perceived to be at a disadvantage due to its relatively young age, underdeveloped evidence base, and small economic clout as compared to other fields

Summary

Introduction

The costs of health care provision in the United States is estimated to exceed $4 trillion (T) in the year 2020.1 More than half of this amount is expended for hospital care ($1.3T) and physician and clinical services ($794B). There may be various examples of this occurring in everyday practice but an instance with especially high stakes is the dreaded competitive bidding process that is frequently utilized, or at least proposed, by institutional payers, including the Centers for Medicare and Medicaid Services.[7] In some such scenarios, O&P providers may have to contend against other bidders from outside the actual profession.

Results

Conclusion