Operating on commission: analyzing how physician financial incentives affect surgery rates

Health Econ. 2010 May;19(5):562-80. doi: 10.1002/hec.1495.

Abstract

This paper employs a nationally representative, household-based dataset in order to test how the compensation method of both the specialists and the primary care providers affects surgery rates. After controlling for adverse selection, I find that when specialists are paid through a fee-for-system scheme rather than on a capitation basis, surgery rates increase 78%. The impact of primary care physician compensation on surgery rates depends on whether or not referral restrictions are present.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Capitation Fee*
  • Decision Making
  • Elective Surgical Procedures / economics
  • Elective Surgical Procedures / statistics & numerical data
  • Fee-for-Service Plans / economics*
  • Fee-for-Service Plans / statistics & numerical data
  • Female
  • Health Care Surveys
  • Humans
  • Insurance, Health / classification
  • Insurance, Health / economics
  • Male
  • Patient Selection
  • Physician Incentive Plans / economics*
  • Physician Incentive Plans / statistics & numerical data
  • Physicians, Family / economics
  • Physicians, Family / statistics & numerical data
  • Practice Patterns, Physicians' / economics*
  • Practice Patterns, Physicians' / statistics & numerical data
  • Referral and Consultation / economics
  • Referral and Consultation / statistics & numerical data
  • Specialties, Surgical / economics
  • Specialties, Surgical / statistics & numerical data
  • Surgical Procedures, Operative / economics*
  • Surgical Procedures, Operative / statistics & numerical data