Are these issues relevant in markets dominated by managed care? Yes. One needs the same information to set a price or to evaluate a contract. Accept- ing a contract in which marginal revenue is less than incremental cost almost never makes sense because such a situation reduces profits. Such contracts make sense only when these losses are really marketing expenses, and even in these cases the money probably could be better spent elsewhere. Similarly, giving a large discount to a buyer who is not sensitive to price almost never makes sense. For example, a managed care plan that needs your organiza- tion’s participation to offer a competitive network is not in a good bargaining position and should not get the best discount.
The flip side of the pricing problem, contracting, is even tougher. Eco- nomic models of pricing tell us that managers need to know what their incre- mental costs are, what markup over incremental costs they should expect, and what their rivals will bid. Each of these will be uncertain to some degree, and many healthcare firms have only sketchy cost data. This fact is especially true for incremental costs, which many firms are not prepared to track. Without good data on incremental costs, managers will be flying blind and may be tempted to base their bids on average costs. This reaction usually costs some profitable business opportunities.
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