Health-Care Payment Systems: Cost and Quality Incentives—Comment

This note analyzes the incentives for cost reduction that different payment policies provide to profit-maximizing health-care providers. Ching-to Albert Ma (1994) proposes a reimbursement mechanism that seeks to induce first-best cost reduction by using a combination of cost reimbursement and prospective payment in a model where higher effort on the part of the health-care provider reduces treatment costs. This note shows that a mechanism of this type, generally, will not result in first-best cost reduction. However, such a mechanism is optimal when the payer has efficiency and distributional concerns.