Universität zu Köln

Brosig-Koch, Jeannette, Hennig-Schmidt, Heike, Kairies-Schwarz, Nadja and Wiesen, Daniel (2017). THE EFFECTS OF INTRODUCING MIXED PAYMENT SYSTEMS FOR PHYSICIANS: EXPERIMENTAL EVIDENCE. Health Econ., 26 (2). S. 243 - 263. HOBOKEN: WILEY. ISSN 1099-1050

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Abstract

Mixed payment systems have become a prominent alternative to paying physicians through fee-for-service and capitation. While theory shows mixed payment systems to be superior, causal effects on physicians' behavior when introducing mixed systems are not well understood empirically. We systematically analyze the influence of fee-for-service, capitation, and mixed payment systems on physicians' service provision. In a controlled laboratory setting, we implement an exogenous variation of the payment method. Medical and non-medical students in the role of physicians in the lab (N = 213) choose quantities of medical services affecting patients' health outside the lab. Behavioral data reveal significant overprovision of medical services under fee-for-service and significant underprovision under capitation, although less than predicted when assuming profit maximization. Introducing mixed payment systems significantly reduces deviations from patient-optimal treatment. Although medical students tend to be more patient regarding, our results hold for both medical and non-medical students. Responses to incentive systems can be explained by a behavioral model capturing individual altruism. In particular, we find support that altruism plays a role in service provision and can partially mitigate agency problems, but altruism is heterogeneous in the population. Copyright (C) 2015 John Wiley & Sons, Ltd.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Brosig-Koch, Jeannette UNSPECIFIED UNSPECIFIED UNSPECIFIED Hennig-Schmidt, Heike UNSPECIFIED UNSPECIFIED UNSPECIFIED Kairies-Schwarz, Nadja UNSPECIFIED UNSPECIFIED UNSPECIFIED Wiesen, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-240483
DOI:	10.1002/hec.3292
Journal or Publication Title:	Health Econ.
Volume:	26
Number:	2
Page Range:	S. 243 - 263
Date:	2017
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1099-1050
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language OTHER-REGARDING BEHAVIOR; IMPURE ALTRUISM; SOMERS-D; HEALTH; INCENTIVES; DOCTORS; MULTITASKING; PERSONALITY; STATISTICS; PROVISION Multiple languages Economics; Health Care Sciences & Services; Health Policy & Services Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/24048