medical equipment, begun in 2009, has been described by economist Peter Cramton as "a train wreck waiting to happen." The CMS auction starts by accepting the lowest bidder and working its way up until tbere are enough providers to meet the demand. All providers are then reimbursed at the median of all accepted bids. One drawback is that providers who might find the reimbursement rate unacceptably low are not obligated to sign a contract. Cramton, along witb mathematician Sean Ellermeyer and economist Brett Katzman, performed a mathematical analysis showing that the CMS auction is likely to result in shortages, low quality and service, increased fraud, and increased costs. One problem is tbat a good auction design should bave an equilibrium bidding strategy that bidders will tend to discover over time, sucb tbat no bidder can do better by switching to a different strategy. The CMS auction has infinitely many sucb strategies, making it hard for bidders to know what to do. One sucb strategy is to bid a ridiculously low amount, since a single low bid is unlikely to lower the median, and tbe bidder is almost certain to win tbe auction. If many providers use this strategy, the final reimbursement rate will be too low, and most providers will decline tbe contract. Simulations demonstrated that tbe CMS auction would fail miserably. It is unclear bow tbe auctions did because CMS has not revealed tbe bids.

Ce document est protégé par la loi sur le droit d'auteur. L'utilisation des services d'Érudit (y compris la reproduction) est assujettie à sa politique d'utilisation que vous pouvez consulter en ligne.