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Multitasking, Quality and Pay for Performance

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  • Kaarbøe, Oddvar M.

    ()
    (University of Bergen, Department of Economics)

  • Siciliani, Luigi

    ()
    (Department of Economics and Related Studies, and Centre for Health Economics, University of York)

Abstract

We present a model of optimal contracting between a purchaser and a provider of health services when quality has two dimensions. We assume that one dimension of quality is veri?able (dimension 1) and one dimension is not verifiable (dimension 2). We show that the power of the incentive scheme for the verifiable dimension depends critically on the extent to which quality 1 increases or decreases the provider's marginal disutility and the patients' marginal benefit from quality 2 (i.e. substitutability or complementarity). Our main result is that under some circumstances a high-powered incentive scheme can be optimal even when the two quality dimensions are substitutes.

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File URL: http://www.uib.no/filearchive/No.%207-08.pdf
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Bibliographic Info

Paper provided by University of Bergen, Department of Economics in its series Working Papers in Economics with number 07/08.

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Length: 37 pages
Date of creation: 23 Mar 2011
Date of revision:
Handle: RePEc:hhs:bergec:2008_007

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Postal: Institutt for økonomi, Universitetet i Bergen, Postboks 7802, 5020 Bergen, Norway
Phone: (+47)55589200
Fax: (+47)55589210
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Web page: http://www.uib.no/econ/en
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Related research

Keywords: quality; altruism; pay for performance.;

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References

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  1. Billy Jack, 2001. "Purchasing Health Care Services from Providers with Unknown Altruism," Working Papers gueconwpa~03-03-13, Georgetown University, Department of Economics.
  2. Ma, Ching-to Albert, 1994. "Health Care Payment Systems: Cost and Quality Incentives," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 3(1), pages 93-112, Spring.
  3. Mougeot, Michel & Naegelen, Florence, 2005. "Hospital price regulation and expenditure cap policy," Journal of Health Economics, Elsevier, vol. 24(1), pages 55-72, January.
  4. Chalkley, M. & Malcomson, J.M., 1995. "Contracting for health services with unmonitored quality," Discussion Paper Series In Economics And Econometrics 9510, Economics Division, School of Social Sciences, University of Southampton.
  5. Pope, Gregory C., 1989. "Hospital nonprice competition and medicare reimbursement policy," Journal of Health Economics, Elsevier, vol. 8(2), pages 147-172, June.
  6. Chalkley, Martin & Malcomson, James M., 1998. "Contracting for health services when patient demand does not reflect quality," Journal of Health Economics, Elsevier, vol. 17(1), pages 1-19, January.
  7. Holmstrom, Bengt & Milgrom, Paul, 1991. "Multitask Principal-Agent Analyses: Incentive Contracts, Asset Ownership, and Job Design," Journal of Law, Economics and Organization, Oxford University Press, vol. 7(0), pages 24-52, Special I.
  8. BOADWAY, Robin & MARCHAND, Maurice & SATO, Motohiro, 2003. "An optimal contract approach to hospital financing," CORE Discussion Papers 2003021, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
  9. Ellis, Randall P., 1998. "Creaming, skimping and dumping: provider competition on the intensive and extensive margins1," Journal of Health Economics, Elsevier, vol. 17(5), pages 537-555, October.
  10. Baker, George P, 1992. "Incentive Contracts and Performance Measurement," Journal of Political Economy, University of Chicago Press, vol. 100(3), pages 598-614, June.
  11. Hugh Gravelle & Matt Sutton & Ada Ma, 2008. "Doctor Behaviour Under a Pay for Performance Contract: Further Evidence from the Quality and Outcomes Framework," Working Papers 034cherp, Centre for Health Economics, University of York.
  12. Ellis, Randall P. & McGuire, Thomas G., 1990. "Optimal payment systems for health services," Journal of Health Economics, Elsevier, vol. 9(4), pages 375-396, December.
  13. Eggleston, Karen, 2005. "Multitasking and mixed systems for provider payment," Journal of Health Economics, Elsevier, vol. 24(1), pages 211-223, January.
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Citations

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Cited by:
  1. Kantarevic, Jasmin & Kralj, Boris, 2012. "Link between Pay for Performance Incentives and Physician Payment Mechanisms: Evidence from the Diabetes Management Incentive in Ontario," IZA Discussion Papers 6474, Institute for the Study of Labor (IZA).
  2. Brekke, Kurt R. & Siciliani, Luigi & Straume, Odd Rune, 2011. "Quality competition with profit constraints: Do non-profit firms provide higher quality than for-profit firms?," Discussion Paper Series in Economics 2/2011, Department of Economics, Norwegian School of Economics.
  3. Janueleviciute, Jurgita & Askildsen, Jan Erik & Kaarbøe, Oddvar & Siciliani, Luigi & Sutton, Matt, 2013. "How Do Hospitals Respond To Price Changes?Evidence From Norway," Working Papers in Economics 15/12, University of Bergen, Department of Economics.
  4. Brekke, Kurt R. & Siciliani, Luigi & Straume, Odd Rune, 2014. "Hospital Mergers with Regulated Prices," Discussion Paper Series in Economics 21/2014, Department of Economics, Norwegian School of Economics.
  5. Jeannette Brosig-Koch & Heike Hennig-Schmidt & Nadja Kairies & Daniel Wiesen, 2013. "How Effective are Pay-for-Performance Incentives for Physicians? – A Laboratory Experiment," Ruhr Economic Papers 0413, Rheinisch-Westfälisches Institut für Wirtschaftsforschung, Ruhr-Universität Bochum, Universität Dortmund, Universität Duisburg-Essen.
  6. Siciliani, Luigi & Rune Straume, Odd & Cellini, Roberto, 2013. "Quality competition with motivated providers and sluggish demand," Journal of Economic Dynamics and Control, Elsevier, vol. 37(10), pages 2041-2061.
  7. Søren Rud Kristensen & Luigi Siciliani & Matt Sutton, 2014. "Optimal Price-Setting in Pay for Performance Schemes in Health Care," Discussion Papers 14/03, Department of Economics, University of York.
  8. Ching-to Albert MA & Henry Y. Mak, 2012. "Information Disclosure and the Equivalence of Prospective Payment and Cost Reimbursement," Boston University - Department of Economics - Working Papers Series WP2012-008, Boston University - Department of Economics.
  9. Iezzi, Elisa & Lippi Bruni, Matteo & Ugolini, Cristina, 2014. "The role of GP's compensation schemes in diabetes care: Evidence from panel data," Journal of Health Economics, Elsevier, vol. 34(C), pages 104-120.

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