Game Theoretical Models for Cooperative Competition in the Healthcare Industry

Abstract

Game theoretical models inform health system design and policy decisions within the context of cooperative competition and shared social missions. The interaction between providers is best represented as a non-cooperative strategic game wherein the players are health care providers—these can be individuals, groups, or large organizations, depending on the scope of the model. In general, the gaming scenario arises when multiple providers are responsible for the same health care service. The goals of our study are directed by the IHI Triple Aim: 1) Reduce the per capita cost of care, 2) Enhance the patient experience of care, and 3) Improve the health of the population. The prisoner’s dilemma results in waste and inefficient allocation of resources. With this awareness, strategies can be developed to reduce the per capita cost of care. The volunteer’s dilemma leads to failure to provide care in time. Research into the problem will provide insight into how to enhance the patient experience of care, especially in terms of reliability. And in the broadest terms, our economic model to achieve fair division of health care services among regional providers will be designed to improve the health of the population. These methods leverage mathematical optimization and economic models to identify strategies, policies, and behaviors that mutually benefit providers, patients, and society, incorporating systemic tradeoffs within and between decision-makers to balance effort, profit, or market share with patient and population welfare and economic stewardship.