Physician response to pay-for-performance: evidence from a natural experiment.

Abstract:

:This study exploits a natural experiment in the province of Ontario, Canada, to identify the impact of pay-for-performance (P4P) incentives on the provision of targeted primary care services and whether physicians' responses differ by age, size of patient population, and baseline compliance level. We use administrative data that cover the full population of Ontario and nearly all the services provided by primary care physicians. We employ a difference-in-differences approach that controls for selection on observables and selection on unobservables that may cause estimation bias. We implement a set of robustness checks to control for confounding from other contemporaneous interventions of the primary care reform in Ontario. The results indicate that responses were modest and that physicians responded to the financial incentives for some services but not others. The results provide a cautionary message regarding the effectiveness of employing P4P to increase the quality of health care.

journal_name

Health Econ

journal_title

Health economics

authors

Li J,Hurley J,DeCicca P,Buckley G

doi

10.1002/hec.2971

subject

Has Abstract

pub_date

2014-08-01 00:00:00

pages

962-78

issue

8

eissn

1057-9230

issn

1099-1050

journal_volume

23

pub_type

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