Risk selection and matching in performance-based contracting

被引:30
作者
Lu, MS
Ma, CTA
Yuan, LS
机构
[1] Univ Calgary, Dept Econ, Calgary, AB T2N 1N4, Canada
[2] Boston Univ, Dept Econ, Boston, MA 02215 USA
[3] Hong Kong Univ Sci & Technol, Hong Kong, Hong Kong, Peoples R China
关键词
incentive contract; performance-based contracting; risk selection; referral; matching; dumping;
D O I
10.1002/hec.734
中图分类号
F [经济];
学科分类号
02 ;
摘要
This paper examines selection and matching incentives of performance-based contracting (PBC) in a model of patient heterogeneity, provider horizontal differentiation and asymmetric information. Treatment effectiveness is affected by the match between a patient's illness severity and a provider's treatment intensity. Before PBC, a provider's revenue is unrelated to treatment effectiveness; therefore, providers supply treatments even if their treatment intensities do not match with the patients' severities. Under PBC, budget allocation is positively related to treatment performance; patient-provider mismatch is reduced because patients are referred more often. Using data from the state of Maine, we show that PBC leads to more referrals and better match between illness severity and treatment intensity. Moreover, we find that PBC has a positive but insignificant effect on dumping. Copyright (C) 2002 John Wiley Sons, Ltd.
引用
收藏
页码:339 / 354
页数:16
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