A game theoretic setting of capitation versus fee-for-service payment systems

Allison Koenecke

PLOS ONE, 2019, vol. 14, issue 10, 1-8

Abstract: We aim to determine whether a game-theoretic model between an insurer and a healthcare practice yields a predictive equilibrium that incentivizes either player to deviate from a fee-for-service to capitation payment system. Using United States data from various primary care surveys, we find that non-extreme equilibria (i.e., shares of patients, or shares of patient visits, seen under a fee-for-service payment system) can be derived from a Stackelberg game if insurers award a non-linear bonus to practices based on performance. Overall, both insurers and practices can be incentivized to embrace capitation payments somewhat, but potentially at the expense of practice performance.

Date: 2019
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0223672

DOI: 10.1371/journal.pone.0223672

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