Publicação
Optimal payment schemes for physicians
| Resumo: | Increasingly, physicians’ payment schemes are being reformed to en- hance performance and to ensure an optimal allocation of scarce medical resources. The empirical evidence points towards the use of mixed payment schemes that appear better at achieving efficiency than either lump sum payments (such as cap- itation) or piece rates (fee for service). Yet, this alleged superiority remains to be established from a theoretical standpoint. The Principal-Agent model developed in this paper offers a contribution in this line, with a primary care physician as agent and a public regulator as principal. Alternative specifications of the princi- pal’s objective function are considered in the model (efficiency versus fairness). Uncertainty is introduced by two random variables that represent the probability for an individual of being ill and his productivity parameter which determines the amount of resources (the physician’s effort in particular) necessary to restore health. The relationship is characterised by information asymmetry since the physician is assumed to observe both variables after the contract has been signed, but before choosing his effort level. Both selection and moral hazard issues are addressed in the model and the results show that, under GP risk neutrality, mixed payment schemes fully correct for both types of information asymmetry. |
|---|---|
| Autores principais: | Levaggi, Rosella |
| Outros Autores: | Rochaix, Lise |
| Assunto: | Primary care Payment schemes Asymmetry of information |
| Ano: | 2003 |
| País: | Portugal |
| Tipo de documento: | artigo |
| Tipo de acesso: | acesso restrito |
| Instituição associada: | Universidade de Lisboa |
| Idioma: | inglês |
| Origem: | Repositório da Universidade de Lisboa |
| _version_ | 1866811367055425536 |
|---|---|
| author | Levaggi, Rosella |
| author2 | Rochaix, Lise |
| author2_role | author |
| author_facet | Levaggi, Rosella Rochaix, Lise |
| author_role | author |
| contributor_name_str_mv | Repositório Científico de Acesso Aberto da ULisboa |
| country_str | PT |
| creators_json_txt | [{\"Person.name\":\"Levaggi, Rosella\"},{\"Person.name\":\"Rochaix, Lise\"}] |
| datacite.contributors.contributor.contributorName.fl_str_mv | Repositório Científico de Acesso Aberto da ULisboa |
| datacite.creators.creator.creatorName.fl_str_mv | Levaggi, Rosella Rochaix, Lise |
| datacite.date.Accepted.fl_str_mv | 2003-08-01T00:00:00Z |
| datacite.date.available.fl_str_mv | 2018-05-23T14:44:04Z |
| datacite.date.embargoed.fl_str_mv | 2018-05-23T14:44:04Z |
| datacite.rights.fl_str_mv | http://purl.org/coar/access_right/c_16ec |
| datacite.subjects.subject.fl_str_mv | Primary care Payment schemes Asymmetry of information |
| datacite.titles.title.fl_str_mv | Optimal payment schemes for physicians |
| dc.contributor.none.fl_str_mv | Repositório Científico de Acesso Aberto da ULisboa |
| dc.creator.none.fl_str_mv | Levaggi, Rosella Rochaix, Lise |
| dc.date.Accepted.fl_str_mv | 2003-08-01T00:00:00Z |
| dc.date.available.fl_str_mv | 2018-05-23T14:44:04Z |
| dc.date.embargoed.fl_str_mv | 2018-05-23T14:44:04Z |
| dc.format.none.fl_str_mv | application/pdf |
| dc.identifier.none.fl_str_mv | http://hdl.handle.net/10400.5/15474 |
| dc.language.none.fl_str_mv | eng |
| dc.publisher.none.fl_str_mv | Springer Verlag |
| dc.rights.none.fl_str_mv | http://purl.org/coar/access_right/c_16ec |
| dc.subject.none.fl_str_mv | Primary care Payment schemes Asymmetry of information |
| dc.title.fl_str_mv | Optimal payment schemes for physicians |
| dc.type.none.fl_str_mv | http://purl.org/coar/resource_type/c_6501 |
| description | Increasingly, physicians’ payment schemes are being reformed to en- hance performance and to ensure an optimal allocation of scarce medical resources. The empirical evidence points towards the use of mixed payment schemes that appear better at achieving efficiency than either lump sum payments (such as cap- itation) or piece rates (fee for service). Yet, this alleged superiority remains to be established from a theoretical standpoint. The Principal-Agent model developed in this paper offers a contribution in this line, with a primary care physician as agent and a public regulator as principal. Alternative specifications of the princi- pal’s objective function are considered in the model (efficiency versus fairness). Uncertainty is introduced by two random variables that represent the probability for an individual of being ill and his productivity parameter which determines the amount of resources (the physician’s effort in particular) necessary to restore health. The relationship is characterised by information asymmetry since the physician is assumed to observe both variables after the contract has been signed, but before choosing his effort level. Both selection and moral hazard issues are addressed in the model and the results show that, under GP risk neutrality, mixed payment schemes fully correct for both types of information asymmetry. |
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| eu_rights_str_mv | restrictedAccess |
| format | article |
| fulltext.url.fl_str_mv | https://repositorio.ulisboa.pt/bitstreams/d5da48a4-bc20-4e88-a3b0-d1e0f4bf77e9/download |
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| identifier.url.fl_str_mv | http://hdl.handle.net/10400.5/15474 |
| instacron_str | ul |
| institution | Universidade de Lisboa |
| instname_str | Universidade de Lisboa |
| language | eng |
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| network_name_str | Repositório da Universidade de Lisboa |
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| organization_str_mv | urn:organizationAcronym:ul |
| person_str_mv | Levaggi, Rosella Rochaix, Lise |
| publishDate | 2003 |
| publisher.none.fl_str_mv | Springer Verlag |
| reponame_str | Repositório da Universidade de Lisboa |
| repository_id_str | urn:repositoryAcronym:ul |
| service_str_mv | urn:repositoryAcronym:ul |
| spelling | engSpringer Verlagpt_PTIncreasingly, physicians’ payment schemes are being reformed to en- hance performance and to ensure an optimal allocation of scarce medical resources. The empirical evidence points towards the use of mixed payment schemes that appear better at achieving efficiency than either lump sum payments (such as cap- itation) or piece rates (fee for service). Yet, this alleged superiority remains to be established from a theoretical standpoint. The Principal-Agent model developed in this paper offers a contribution in this line, with a primary care physician as agent and a public regulator as principal. Alternative specifications of the princi- pal’s objective function are considered in the model (efficiency versus fairness). Uncertainty is introduced by two random variables that represent the probability for an individual of being ill and his productivity parameter which determines the amount of resources (the physician’s effort in particular) necessary to restore health. The relationship is characterised by information asymmetry since the physician is assumed to observe both variables after the contract has been signed, but before choosing his effort level. Both selection and moral hazard issues are addressed in the model and the results show that, under GP risk neutrality, mixed payment schemes fully correct for both types of information asymmetry.application/pdfpt_PTOptimal payment schemes for physiciansLevaggi, RosellaRochaix, LiseHostingInstitutionOrganizationalRepositório Científico de Acesso Aberto da ULisboae-mailmailto:repositorio@reitoria.ulisboa.ptrepositorio@reitoria.ulisboa.ptISSNIsPartOf1617-982X (print)ISSNIsPartOf1617-9838 (online)DOIIsPartOf10.1007/s10258-003-0019-22018-05-23T14:44:04Z2003-082003-08-01T00:00:00ZHandlehttp://hdl.handle.net/10400.5/15474http://purl.org/coar/access_right/c_16ecrestricted accessPrimary carePayment schemesAsymmetry of information187301 bytesliteraturehttp://purl.org/coar/resource_type/c_6501journal articlehttp://purl.org/coar/access_right/c_16ecapplication/pdffulltexthttps://repositorio.ulisboa.pt/bitstreams/d5da48a4-bc20-4e88-a3b0-d1e0f4bf77e9/downloadPortuguese Economic Journal2287107Lisboa |
| spellingShingle | Optimal payment schemes for physicians Levaggi, Rosella Primary care Payment schemes Asymmetry of information |
| status | SINGLETON |
| subject.fl_str_mv | Primary care Payment schemes Asymmetry of information |
| title | Optimal payment schemes for physicians |
| title_full | Optimal payment schemes for physicians |
| title_fullStr | Optimal payment schemes for physicians |
| title_full_unstemmed | Optimal payment schemes for physicians |
| title_short | Optimal payment schemes for physicians |
| title_sort | Optimal payment schemes for physicians |
| topic | Primary care Payment schemes Asymmetry of information |
| topic_facet | Primary care Payment schemes Asymmetry of information |
| url | http://hdl.handle.net/10400.5/15474 |
| visible | 1 |