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Risk selection and matching in performance‐based contracting
Author(s) -
Lu Mingshan,
Albert Ma Chingto,
Yuan Lasheng
Publication year - 2003
Publication title -
health economics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.55
H-Index - 109
eISSN - 1099-1050
pISSN - 1057-9230
DOI - 10.1002/hec.734
Subject(s) - matching (statistics) , selection (genetic algorithm) , revenue , incentive , medicine , actuarial science , business , operations management , microeconomics , economics , computer science , finance , artificial intelligence , pathology
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 © 2002 John Wiley & Sons, Ltd.