Using behavioral economics to design physician incentives that deliver high-value care

Ezekiel J. Emanuel, Peter A. Ubel, Judd B. Kessler, Gregg Meyer, Ralph W. Muller, Amol S. Navathe, Pankaj Patel, Robert Pearl, Meredith B. Rosenthal, Lee Sacks, Aditi P. Sen, Paul Sherman, Kevin G. Volpp

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)114-119
Number of pages6
JournalAnnals of internal medicine
Volume164
Issue number2
DOIs
StatePublished - Jan 19 2016

ASJC Scopus subject areas

  • Internal Medicine

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    Emanuel, E. J., Ubel, P. A., Kessler, J. B., Meyer, G., Muller, R. W., Navathe, A. S., Patel, P., Pearl, R., Rosenthal, M. B., Sacks, L., Sen, A. P., Sherman, P., & Volpp, K. G. (2016). Using behavioral economics to design physician incentives that deliver high-value care. Annals of internal medicine, 164(2), 114-119. https://doi.org/10.7326/M15-1330