Brosig-Koch Jeannette, Groß Mona, Hennig-Schmidt Heike, Kairies-Schwarz Nadja, Wiesen Daniel
Faculty of Economics and Management, Otto von Guericke University Magdeburg, Magdeburg, Germany.
Health Economics Research Center CINCH, University of Duisburg-Essen, Essen, Germany.
Int J Health Econ Manag. 2025 Mar 19. doi: 10.1007/s10754-025-09390-x.
How performance pay affects physicians' medical service provision and the quality of care is relevant for researchers and policy-makers alike. This paper systematically studies how performance pay, complementing either fee-for-service or capitation, affects physicians' medical service provision and the quality of care for heterogeneous patients. Using a series of controlled behavioral experiments with physicians and students, we test the incentive effect of performance pay at a within-subject level. We consider a performance pay scheme which grants a discrete bonus if a quality threshold is reached, which varies with the patients' severity of illness. We find that performance pay significantly reduces non-optimal service provision and enhances the quality of care. Effect sizes depend on the patients' severity of illness and whether performance pay is blended with fee-for-service or capitation. Health policy implications, including a cost benefit analysis of introducing performance pay, are discussed.
绩效薪酬如何影响医生的医疗服务提供和医疗质量，这对研究人员和政策制定者来说都至关重要。本文系统地研究了作为按服务收费或按人头付费补充形式的绩效薪酬，如何影响医生对不同患者的医疗服务提供和医疗质量。通过对医生和学生进行一系列对照行为实验，我们在受试者内部层面测试了绩效薪酬的激励效果。我们考虑一种绩效薪酬方案，即如果达到质量阈值（该阈值随患者病情严重程度而变化），则给予一次性奖金。我们发现，绩效薪酬显著减少了非最优服务提供，并提高了医疗质量。效应大小取决于患者的病情严重程度以及绩效薪酬是否与按服务收费或按人头付费相结合。本文还讨论了健康政策影响，包括引入绩效薪酬的成本效益分析。
