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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

Ellen P Green

ASU Health Solutions

Katherine S Peterson

Mayo Clinic Hospital - Phoenix; Arizona State University (ASU)

Katherine Markiewicz

Mayo Clinic

Janet O’Brien

Arizona State University, College of Nursing and Health Innovation

Noël M Arring

Mayo Clinic

Date Written: November 1, 2017

Abstract

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

Green, Ellen P and Peterson, Katherine S and Markiewicz, Katherine and O’Brien, Janet and Arring, Noël M, The Impact of a Merit-Based Incentive Payment System on Quality of Healthcare: A Framed Field Experiment (November 1, 2017). Available at SSRN: https://ssrn.com/abstract=3066257

Ellen Green (Contact Author)

ASU Health Solutions ( email )

Nursing and Health Innovation Buildings 1 and 2
500 N. 3rd Street
Phoenix, AZ 85004
United States

Katherine Peterson

Mayo Clinic Hospital - Phoenix ( email )

5777 E Mayo Blvd
Phoenix, AZ 85054
United States

Arizona State University (ASU) ( email )

Farmer Building 440G PO Box 872011
Tempe, AZ 85287
United States

Katherine Markiewicz

Mayo Clinic ( email )

200 First Street SW
Rochester, MN 55905
United States

Janet O’Brien

Arizona State University, College of Nursing and Health Innovation ( email )

Farmer Building 440G PO Box 872011
Tempe, AZ 85287
United States
6024961415 (Phone)

Noël Arring

Mayo Clinic ( email )

200 First Street SW
Rochester, MN 55905
United States

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