IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0218154.html
   My bibliography  Save this article

Distribution of monetary incentives in health insurance scheme influences acupuncture treatment choices: An experimental study

Author

Listed:
  • Ye-Seul Lee
  • Song-Yi Kim
  • Younbyoung Chae

Abstract

Background: Understanding how doctors respond to occupational and monetary incentives in health care payment systems is important for determining the effectiveness of such systems. This study examined changes in doctors’ behaviors in response to monetary incentives within health care payment systems in a ceteris paribus setting. Methods: An online experiment was developed to analyze the effect of monetary incentives similar to fee-for-service (FFS) and capitation (CAP) on doctors’ prescription patterns. In the first session, no monetary values were presented. In the second session conducted 1 week later, doctors were randomly assigned to one of two monetary incentive groups (FFS group: n = 25, CAP group: n = 25). In all sessions, doctors were presented with 10 cases and asked to determine the type and number of treatments. Results: In the first session with no monetary incentives, there was no significant difference between the FFS and CAP groups in the number of treatments. When monetary incentives were provided, doctors in the CAP group prescribed fewer treatments than the FFS group. The perceived severity of the cases did not change significantly between sessions and between groups. linear mixed-effects regression model indicated the treatment choices were influenced by monetary incentives, but not by the perceived severity of the patient’s symptoms. Conclusion: The monetary values incentivized the doctors’ treatment choices, but not their professional evaluation of patients. Monetary values designed within health care systems influence the doctor’s decisions in the form of external rewards, in addition to occupational values, and can thus be adjusted by more effective incentives.

Suggested Citation

  • Ye-Seul Lee & Song-Yi Kim & Younbyoung Chae, 2019. "Distribution of monetary incentives in health insurance scheme influences acupuncture treatment choices: An experimental study," PLOS ONE, Public Library of Science, vol. 14(6), pages 1-12, June.
  • Handle: RePEc:plo:pone00:0218154
    DOI: 10.1371/journal.pone.0218154
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0218154
    Download Restriction: no

    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0218154&type=printable
    Download Restriction: no

    File URL: https://libkey.io/10.1371/journal.pone.0218154?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Ye-Seul Lee & Hyun-Seo Song & Hackjin Kim & Younbyoung Chae, 2019. "Altruistic decisions are influenced by the allocation of monetary incentives in a pain-sharing game," PLOS ONE, Public Library of Science, vol. 14(3), pages 1-16, March.
    2. Liran Einav & Amy Finkelstein & Stephen P. Ryan & Paul Schrimpf & Mark R. Cullen, 2013. "Selection on Moral Hazard in Health Insurance," American Economic Review, American Economic Association, vol. 103(1), pages 178-219, February.
    3. Lagarde, Mylène & Blaauw, Duane, 2017. "Physicians’ responses to financial and social incentives: A medically framed real effort experiment," Social Science & Medicine, Elsevier, vol. 179(C), pages 147-159.
    4. Banuri, Sheheryar & de Walque, Damien & Keefer, Philip & Haidara, Ousmane Diadie & Robyn, Paul Jacob & Ye, Maurice, 2018. "The use of video vignettes to measure health worker knowledge. Evidence from Burkina Faso," Social Science & Medicine, Elsevier, vol. 213(C), pages 173-180.
    5. Dumont, Etienne & Fortin, Bernard & Jacquemet, Nicolas & Shearer, Bruce, 2008. "Physicians' multitasking and incentives: Empirical evidence from a natural experiment," Journal of Health Economics, Elsevier, vol. 27(6), pages 1436-1450, December.
    6. Jeffrey Clemens & Joshua D. Gottlieb, 2014. "Do Physicians' Financial Incentives Affect Medical Treatment and Patient Health?," American Economic Review, American Economic Association, vol. 104(4), pages 1320-1349, April.
    7. Hennig-Schmidt, Heike & Selten, Reinhard & Wiesen, Daniel, 2011. "How payment systems affect physicians' provision behaviour--An experimental investigation," Journal of Health Economics, Elsevier, vol. 30(4), pages 637-646, July.
    8. Roland Bénabou & Jean Tirole, 2003. "Intrinsic and Extrinsic Motivation," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 70(3), pages 489-520.
    9. Aviva Aron-Dine & Liran Einav & Amy Finkelstein & Mark Cullen, 2015. "Moral Hazard in Health Insurance: Do Dynamic Incentives Matter?," The Review of Economics and Statistics, MIT Press, vol. 97(4), pages 725-741, October.
    10. Hennig-Schmidt, Heike & Wiesen, Daniel, 2014. "Other-regarding behavior and motivation in health care provision: An experiment with medical and non-medical students," Social Science & Medicine, Elsevier, vol. 108(C), pages 156-165.
    11. Allard, Marie & Jelovac, Izabela & Léger, Pierre Thomas, 2011. "Treatment and referral decisions under different physician payment mechanisms," Journal of Health Economics, Elsevier, vol. 30(5), pages 880-893.
    12. Green, Ellen P., 2014. "Payment systems in the healthcare industry: An experimental study of physician incentives," Journal of Economic Behavior & Organization, Elsevier, vol. 106(C), pages 367-378.
    13. Soonman Kwon, 2003. "Health and Health Care," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 62(1), pages 171-186, April.
    14. Martijn Ludwig & Frits Merode & Wim Groot, 2010. "Principal agent relationships and the efficiency of hospitals," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(3), pages 291-304, June.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Finocchiaro Castro, Massimo & Guccio, Calogero & Romeo, Domenica, 2022. "A systematic literature review of 10 years of behavioral research on health services," EconStor Preprints 266248, ZBW - Leibniz Information Centre for Economics.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Attema, Arthur E. & Galizzi, Matteo M. & Groß, Mona & Hennig-Schmidt, Heike & Karay, Yassin & L’Haridon, Olivier & Wiesen, Daniel, 2023. "The formation of physician altruism," Journal of Health Economics, Elsevier, vol. 87(C).
    2. Jeannette Brosig‐Koch & Heike Hennig‐Schmidt & Nadja Kairies‐Schwarz & Daniel Wiesen, 2017. "The Effects of Introducing Mixed Payment Systems for Physicians: Experimental Evidence," Health Economics, John Wiley & Sons, Ltd., vol. 26(2), pages 243-262, February.
    3. Castro, M.F.; & Ferrara, P.; & Guccio, C.; & Lisi, D.;, 2018. "Medical Malpractice Liability and Physicians’ Behavior:Experimental Evidence," Health, Econometrics and Data Group (HEDG) Working Papers 18/11, HEDG, c/o Department of Economics, University of York.
    4. Brosig-Koch, Jeannette & Hennig-Schmidt, Heike & Kairies-Schwarz, Nadja & Kokot, Johanna & Wiesen, Daniel, 2024. "A new look at physicians’ responses to financial incentives: Quality of care, practice characteristics, and motivations," Journal of Health Economics, Elsevier, vol. 94(C).
    5. Castro, Massimo Finocchiaro & Ferrara, Paolo Lorenzo & Guccio, Calogero & Lisi, Domenico, 2019. "Medical malpractice liability and physicians’ behavior: Experimental evidence," Journal of Economic Behavior & Organization, Elsevier, vol. 166(C), pages 646-666.
    6. Waibel, Christian & Wiesen, Daniel, 2021. "An experiment on referrals in health care," European Economic Review, Elsevier, vol. 131(C).
    7. Huck, Steffen & Lünser, Gabriele & Spitzer, Florian & Tyran, Jean-Robert, 2016. "Medical insurance and free choice of physician shape patient overtreatment: A laboratory experiment," Journal of Economic Behavior & Organization, Elsevier, vol. 131(PB), pages 78-105.
    8. Cox, James C. & Sadiraj, Vjollca & Schnier, Kurt E. & Sweeney, John F., 2016. "Incentivizing cost-effective reductions in hospital readmission rates," Journal of Economic Behavior & Organization, Elsevier, vol. 131(PB), pages 24-35.
    9. Jeannette Brosig‐Koch & Burkhard Hehenkamp & Johanna Kokot, 2017. "The effects of competition on medical service provision," Health Economics, John Wiley & Sons, Ltd., vol. 26(S3), pages 6-20, December.
    10. Bardey, David & Kembou, Samuel & Ventelou, Bruno, 2021. "Physicians’ incentives to adopt personalised medicine: Experimental evidence," Journal of Economic Behavior & Organization, Elsevier, vol. 191(C), pages 686-713.
    11. Balafoutas, Loukas & Kerschbamer, Rudolf, 2020. "Credence goods in the literature: What the past fifteen years have taught us about fraud, incentives, and the role of institutions," Journal of Behavioral and Experimental Finance, Elsevier, vol. 26(C).
    12. Jeannette Brosig‐Koch & Burkhard Hehenkamp & Johanna Kokot, 2023. "Who benefits from quality competition in health care? A theory and a laboratory experiment on the relevance of patient characteristics," Health Economics, John Wiley & Sons, Ltd., vol. 32(8), pages 1785-1817, August.
    13. Finocchiaro Castro Massimo & Lisi Domenico & Romeo Domenica, 2024. "An Experimental Analysis of Patient Dumping Under Different Payment Systems," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 24(1), pages 205-258, January.
    14. Finocchiaro Castro, Massimo & Ferrara, Paolo Lorenzo & Guccio, Calogero & Lisi, Domenico, 2021. "Optimal mixed payment system and medical liability. A laboratory study," MPRA Paper 110276, University Library of Munich, Germany.
    15. Wang, Jian & Iversen, Tor & Hennig-Schmidt, Heike & Godager, Geir, 2020. "Are patient-regarding preferences stable? Evidence from a laboratory experiment with physicians and medical students from different countries," European Economic Review, Elsevier, vol. 125(C).
    16. Ye-Seul Lee & Hyun-Seo Song & Hackjin Kim & Younbyoung Chae, 2019. "Altruistic decisions are influenced by the allocation of monetary incentives in a pain-sharing game," PLOS ONE, Public Library of Science, vol. 14(3), pages 1-16, March.
    17. Cadena, Brian C. & Smith, Austin C., 2022. "Performance pay, productivity, and strategic opt-out: Evidence from a community health center," Journal of Public Economics, Elsevier, vol. 206(C).
    18. Ben Greiner & Le Zhang & Chengxiang Tang, 2017. "Separation of prescription and treatment in health care markets: A laboratory experiment," Health Economics, John Wiley & Sons, Ltd., vol. 26(S3), pages 21-35, December.
    19. Galina Besstremyannaya & Sergei Golovan, 2019. "Physician’s altruism in incentive contracts: Medicare’s quality race," CINCH Working Paper Series 1903, Universitaet Duisburg-Essen, Competent in Competition and Health.
    20. Sebastian Neumann-Böhme & Stefan A. Lipman & Werner B. F. Brouwer & Arthur E. Attema, 2021. "Trust me; I know what I am doing investigating the effect of choice list elicitation and domain-relevant training on preference reversals in decision making for others," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(5), pages 679-697, July.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0218154. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.