Department of Economics

Payment Mechanisms in the Healthcare Industry: An Experimental Study of Physician Incentives in a Multiple Principal Agent Setting

Department of Economics
University of Delaware
Working Paper #2012-11

Payment Mechanisms in the Healthcare Industry: An Experimental Study of Physician Incentives in a Multiple Principal Agent Setting

Ellen P. Green

ABSTRACT

Current failures in the healthcare industry emphasize the need for a more fundamental understanding of how these contracts incentivize doctors. To aid this understanding, we treat the established physician-client-employer relationship as a multiple principal agent problem. We use a laboratory experiment, with a real-effort task, to test the relative performance of common payment mechanisms employed in this dual-principal agent relationship (Piece Rate, Flat Rate, Salary, Bonus, and Socialization). This study suggests, contrary to standard contract theory, that relying on extrinsic incentives to motivate physicians may be detrimental and costly for the healthcare industry.

 

JEL Codes:I10, I12, I18, J01, J3, L2

Keywords: Multiple principal agent theory, intrinsic motivation, other-regarding behavior, Fee-For-Service, Capitation, Salary

The Lerner College is home to a state-of-the-art financial trading facility, the $1.5 million student-led Blue Hen Investment Club, a student-managed restaurant and hotel, a high-technology development center of a global bank and a start-up experience for students with new business ideas.

Lerner College faculty - like Meryl Gardner, whose research on foods and moods was recently published in the Journal of Consumer Psychology - are thought leaders who command attention from influential business audiences, economists and policy makers.

All Lerner College departments offer discovery learning experiences and emphasize data-based analytics to enrich the student experience. Here, students at Vita Nova, our award-winning restaurant run through HRIM, joined professional chefs and winemakers in hosting a 2014 Mid-Atlantic Wine and Food Festival event.

The Institute for Financial Services Analytics is a collaboration between the Lerner College, UD's College of Engineering and JPMorgan Chase, and hosts events for academics and the business community designed to address consumer analytics and industry applications.

Undergraduate scholarships, made possible through the generosity of alumni and friends, enable us to support promising scholars. Here, Delaware Gov. Jack Markell and his mother, Leni Markell, join recipients of the William Markell Scholarship (center), which benefits students in Accounting and MIS.

  • Alfred Lerner College of Business & Economics
    303 Alfred Lerner Hall  •  Newark, DE 19716  •  USA  •  ©