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Custom-made health-care: an experimental investigation

Keser, Claudia; Montmarquette, Claude; Schmidt, Martin; Schnitzler, Cornelius

Abstract:
Background: Physicians’ financial interests might conflict with the best service to patients. It is essential to gain a thorough understanding of the effect of remuneration systems on physician behaviour.
Methods: We conducted a controlled laboratory experiment using a within-subject design to investigate physician behaviour underpayment heterogeneity. Each physician provided medical care to patients whose treatments were paid for under fee-for-service (FFS) or capitation (CAP).
Results: We observed that physicians customized their care in response to the payment system. FFS patients received considerably more medical care than did CAP patients with the same illness and treatment preference. Physicians over-served FFS patients and under-served CAP patients. After a CAP payment reduction, we observed neither a quantity reduction under CAP nor a spillover in FFS patients’ treatment.
Conclusions: The results suggest that, in our experimental model, fee regulation can be used to some extent to control physician spending since we did not identify a behavioural response to the CAP payment cut. Physicians did not recoup lost income by altering treatment behaviour toward CAP and/or FFS patients. ... mehr

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Verlagsausgabe §
DOI: 10.5445/IR/1000129398
Veröffentlicht am 05.02.2021
Cover der Publikation
Zugehörige Institution(en) am KIT Institut für Volkswirtschaftslehre (ECON)
Publikationstyp Zeitschriftenaufsatz
Publikationsmonat/-jahr 12.2020
Sprache Englisch
Identifikator ISSN: 2191-1991
KITopen-ID: 1000129398
Erschienen in Health economics review
Verlag SpringerOpen
Band 10
Heft 1
Seiten Art.-Nr.: 41
Vorab online veröffentlicht am 18.12.2020
Schlagwörter Experimental economics, Physician reimbursement, Capitation, Fee-for-service, Fee regulation
Nachgewiesen in Scopus
Web of Science
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