The Impact of a Merit-Based Incentive Payment System on Quality of Healthcare: A Framed Field Experiment
18 Pages Posted: 8 Nov 2017 Last revised: 10 Nov 2017
Date Written: November 1, 2017
We study the impact of a merit-based incentive payment system on provider behavior in the primary care setting using new experimental methods that leverage healthcare simulations with patient actors. Our approach allows us to exogenously change a provider’s incentives and to directly measure the consequences of alternative payment systems. Within our sample, we find that merit-based incentive payment systems increase the number of the incentivized outcome measures met, but lower overall quality of care through unintended effects on other indicators of care.
Keywords: MACRA, Medicare Access and Chip Reauthorization Act, pay-for-performance, MIPS, Experimental Design, Framed Field Experiment
JEL Classification: I1, C9
Suggested Citation: Suggested Citation