The Impact of a Merit-Based Incentive Payment System on Quality of Healthcare: A Framed Field Experiment
31 Pages Posted: 8 Nov 2017 Last revised: 25 Jan 2019
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 measures met, but also lower quality of care through unintended effects on adherence to standards of care and patient satisfaction.
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