| 来源类型 | Working Paper |
| 规范类型 | 报告 |
| DOI | 10.3386/w27172 |
| 来源ID | Working Paper 27172 |
| Optimal Contracting with Altruistic Agents: A Structural Model of Medicare Payments for Dialysis Drugs | |
| Martin Gaynor; Nirav Mehta; Seth Richards-Shubik | |
| 发表日期 | 2020-05-18 |
| 出版年 | 2020 |
| 语种 | 英语 |
| 摘要 | We study physician agency and optimal payment policy in the context of an expensive medication used in dialysis care. Using Medicare claims data we estimate a structural model of treatment decisions, in which physicians differ in their altruism and marginal costs, and this heterogeneity is unobservable to the government. In a novel application of nonlinear pricing methods, we theoretically characterize the optimal unrestricted contract in this screening environment with multidimensional heterogeneity. We combine these results with the estimated model to construct the optimal contract and simulate counterfactual outcomes. The optimal contract is a flexible fee-for-service contract, which pays for reported treatments but uses variable marginal payments instead of constant reimbursement rates, resulting in substantial health improvements and reductions in costs. Our structural approach also yields important qualitative findings, such as rejecting the optimality of any linear contract, and may be employed more broadly to analyze a variety of applications. |
| 主题 | Microeconomics ; Economics of Information ; Public Economics ; National Fiscal Issues ; Health, Education, and Welfare ; Health ; Industrial Organization ; Market Structure and Firm Performance |
| URL | https://www.nber.org/papers/w27172 |
| 来源智库 | National Bureau of Economic Research (United States) |
| 引用统计 | |
| 资源类型 | 智库出版物 |
| 条目标识符 | http://119.78.100.153/handle/2XGU8XDN/584845 |
| 推荐引用方式 GB/T 7714 | Martin Gaynor,Nirav Mehta,Seth Richards-Shubik. Optimal Contracting with Altruistic Agents: A Structural Model of Medicare Payments for Dialysis Drugs. 2020. |
| 条目包含的文件 | ||||||
| 文件名称/大小 | 资源类型 | 版本类型 | 开放类型 | 使用许可 | ||
| w27172.pdf（922KB） | 智库出版物 | 限制开放 | CC BY-NC-SA | 浏览 | ||
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