Essays in Healthcare Economics

[摘要] Many firms attempting to increase profits will implement performance-based pay- ment systems to incentivize more production from their workers. The economics liter- ature generally finds performance-based payments significantly increase firm output. However, the healthcare literature tends to be more ambiguous. In this paper, I an- alyze a network of healthcare clinics which introduced performance-based bonuses. Beginning in 2017, the clinic set a work relative value unit (wRVU) target each provider (mostly physicians) was expected to achieve, and a bonus payment was earned if the provider exceeded the target each quarter. I find that when the clinic introduced the bonuses, providers increased their wRVUs by approximately 9 − 13 percentage points. I find that this increase in production was driven primarily by providers increasing the number of patients seen each day, not by increasing wRVU per patient or up-coding. Additionally, I find the increased productivity was driven primarily by the lower-performing providers in 2016. However, the higher achieving providers did not exhibit any significant improvement in 2017.

[发布机构] Rice University

[效力级别] economics