Physicians’ multitasking and incentives: Empirical evidence from a natural experiment

How payment systems affect physicians’ provision behaviour—An experimental investigation

“…Accounting for possible selection effects, Sørensen and Grytten (2003) show that primary care physicians in Norway under FFS have more consultations and patient contacts as well as lower referral rates than salaried physicians. Dumont et al (2008) analyse data on primary care services from the Canadian province Quebec before and after a variation from FFS to a mixed system with a base wage-independent of services provided-and a reduced FFS payment. Their results suggest that physicians react to payment incentives by reducing the volume of services, but increasing the time spent per service and per nonclinical service under the mixed payment system.…”

Paying for primary care: A cross-sectional analysis of cost and morbidity distributions across primary care payment models in Ontario Canada

“…For instance, Hutchison et al (1996) conducted a retrospective cohort study to determine the impact of capitation payment on hospital utilization; they found physician payment did not have an effect on utilization rates. In addition, there is considerable literature on physician productivity under different forms of remuneration (e.g., Evans, 1974;Brown and Lapan, 1979;Ellis and McGuire, 1986;Thornton and Eakin, 1997;Conrad et al, 1998Conrad et al, , 2002Fortin et al, 2008;Dumont et al, 2008). There has also been a significant amount of research done, particularly in the US, on risk selection and adverse selection amongst hospitals and insurance plans (e.g., Ellis, 1998;Frank et al, 2000;Luft and Miller, 1988).…”

Incentives for Lawyers

“…Hong et al (2013) found that factory workers in China increased their productivity when new incentive pay was offered for the quantity produced, but the quality of their output decreased. Dumont et al (2008) studied how physicians in Quebec responded to the introduction of an optional mixedcompensation system that combined a fixed per diem with a partial fee for services provided. Physicians who changed from the original fee-for-service plan to the mixed system decreased their billable services but increased the average time spent per service, suggesting there may have been a qualityquantity substitution.…”

“…Outside of manufacturing and agriculture, see Gaynor, Rebitzer, and Taylor (2004), Encinosa, Gaynor, and Rebitzer (2007), Dumont, Fortin, Jacquemet, and Shearer (2008), Lavy (2009), andNeal (2011). 4 For a field experiment in which a change in the incentive pay of managers on a fruit-picking farm affects the allocation of work to the subordinates, see Bandiera, Barankay, and Rasul (2007).…”