Using Behavioral Economics to Design Physician Incentives That Deliver High-Value Care
Using Behavioral Economics to Design Physician Incentives That Deliver High-Value Care
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DOI：
10.7326/m15-1330
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发表时间：
2016-01-19
影响因子：
39.2
通讯作者：
Volpp, Kevin G.
中科院分区：
文献类型：
--
作者：
Emanuel, Ezekiel J.;Ubel, Peter A.;Volpp, Kevin G.
行为经济学为医生提供高价值护理的有效激励机制的发展提供了见解。它表明，激励的结构和传递可以塑造行为，深思熟虑的决策环境设计也可以。本文讨论了行为经济学的几个原则，包括惯性、损失厌恶、选择过载和相对社会排名。尽管这些原则已被应用于激励个人健康决策、退休计划和储蓄行为，但在医生激励计划的设计中，它们在很大程度上被忽视了。将这些原则应用于医生激励可以通过更好地与绩效目标保持一致来提高其有效性。尽管作者承认，将行为经济学原理应用于医生激励的设计在很大程度上是未经检验的，而且存在许多悬而未决的问题，但作者还是提供了一些成功的激励项目的轶事例子。需要应用和严格评估基础设施的变化和激励措施，以设计奖励高质量、有成本意识的护理的支付系统。
Behavioral economics provides insights about the development of effective incentives for physicians to deliver high-value care. It suggests that the structure and delivery of incentives can shape behavior, as can thoughtful design of the decision-making environment. This article discusses several principles of behavioral economics, including inertia, loss aversion, choice overload, and relative social ranking. Whereas these principles have been applied to motivate personal health decisions, retirement planning, and savings behavior, they have been largely ignored in the design of physician incentive programs. Applying these principles to physician incentives can improve their effectiveness through better alignment with performance goals. Anecdotal examples of successful incentive programs that apply behavioral economics principles are provided, even as the authors recognize that its application to the design of physician incentives is largely untested, and many outstanding questions exist. Application and rigorous evaluation of infrastructure changes and incentives are needed to design payment systems that incentivize high-quality, cost-conscious care.