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How Payment Systems Affect Physicians' Provision Behaviour – An Experimental Investigation

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  • Heike Hennig-Schmidt
  • Reinhard Selten
  • Daniel Wiesen

    ()

Abstract

Understanding how physicians respond to incentives from payment schemes is a central concern in health economics research. We introduce a controlled laboratory experiment to analyse the influence of incentives from fee-for-service and capitation payments on physicians’ supply of medical services. In our experiment, physicians choose quantities of medical services for patients with different states of health. We find that physicians provide significantly more services under fee-for-service than under capitation. Patients are overserved under fee-forservice and underserved under capitation. However, payment incentives are not the only motivation for physicians’ quantity choices, as patients’ health benefits are of considerable importance as well. We find that patients in need of a high (low) level of medical services receive a larger health benefit under fee-for-service (capitation).

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Bibliographic Info

Paper provided by University of Bonn, Germany in its series Bonn Econ Discussion Papers with number bgse03_2011.

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Length: 24
Date of creation: Mar 2011
Date of revision:
Handle: RePEc:bon:bonedp:bgse03_2011

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Postal: Bonn Graduate School of Economics, University of Bonn, Adenauerallee 24 - 26, 53113 Bonn, Germany
Fax: +49 228 73 6884
Web page: http://www.bgse.uni-bonn.de

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Keywords: Physician payment system; laboratory experiment; incentives; fee-for-service; capitation;

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References

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Citations

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Cited by:
  1. Kesternich, Iris & Schumacher, Heiner & Winter, Joachim, 2014. "Professional norms and physician behavior: homo oeconomicus or homo hippocraticus?," Discussion Paper Series of SFB/TR 15 Governance and the Efficiency of Economic Systems 456, Free University of Berlin, Humboldt University of Berlin, University of Bonn, University of Mannheim, University of Munich.
  2. Schmitz, Hendrik, 2013. "Practice budgets and the patient mix of physicians – The effect of a remuneration system reform on health care utilisation," Journal of Health Economics, Elsevier, vol. 32(6), pages 1240-1249.
  3. Mayrhofer, Thomas & Krieger, Miriam, 2012. "Patient Preferences and Treatment Thresholds under Diagnostic Risk: An Economic Laboratory Experiment," Annual Conference 2012 (Goettingen): New Approaches and Challenges for the Labor Market of the 21st Century 62033, Verein für Socialpolitik / German Economic Association.
  4. Claudia Keser & Claude Montmarquette & Martin Schmidt & Cornelius Schnitzler, 2013. "Custom-made healthcare – An experimental investigation," CIRANO Working Papers 2013s-15, CIRANO.
  5. Ellen P. Green, 2013. "Payment Systems in the Healthcare Industry: An Experimental Study Of Physician Incentives," Working Papers 13-05, University of Delaware, Department of Economics.
  6. Godager, Geir & Wiesen, Daniel, 2011. "Profit or Patients' Health Benefit? Exploring the Heterogeneity in Physician Altruism," HERO On line Working Paper Series 2011:7, Oslo University, Health Economics Research Programme.
  7. Buckley, Neil J. & Cuff, Katherine & Hurley, Jeremiah & McLeod, Logan & Mestelman, Stuart & Cameron, David, 2012. "An experimental investigation of mixed systems of public and private health care finance," Journal of Economic Behavior & Organization, Elsevier, vol. 84(3), pages 713-729.
  8. Brekke, Kurt R. & Siciliani, Luigi & Straume, Odd Rune, 2012. "Quality competition with profit constraints," Journal of Economic Behavior & Organization, Elsevier, vol. 84(2), pages 642-659.
  9. Jeannette Brosig-Koch & Heike Hennig-Schmidt & Nadja Kairies & Daniel Wiesen, 2013. "How to Improve Patient Care? – An Analysis of Capitation, Fee-for-Service, and Mixed Payment Schemes for Physicians," Ruhr Economic Papers 0412, Rheinisch-Westfälisches Institut für Wirtschaftsforschung, Ruhr-Universität Bochum, Universität Dortmund, Universität Duisburg-Essen.
  10. Sung-Hee Jeon & Jeremiah Hurley, 2010. "Physician Resource Planning in Canada: The Need for a Stronger Behavioural Foundation," Canadian Public Policy, University of Toronto Press, vol. 36(3), pages 359-375, September.

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