Jeannette Brosig-Koch

How Effective are Pay-for-Performance Incentives for Physicians? - A Laboratory Experiment

Recent reforms in health care have introduced a variety of pay-for-performance programs using financial incentives for physicians to improve the quality of care. Their effectiveness is, however, ambiguous as it is often difficult to disentangle the effect of financial incentives from the ones of various other simultaneous changes in the system. In this study we investigate the effects of introducing financial pay-for-performance incentives with the help of controlled laboratory experiments. In particular, we use fee-for-service and capitation as baseline payment schemes and test how additional pay-for-performance incentives affect the medical treatment of different patient types. Our results reveal that, on average, patients significantly benefit from introducing pay-forperformance, independently of hether it is combined with capitation or fee-for-service incentives. The magnitude of this effect is significantly influenced by the patient type, though. These results hold for medical and non-medical students. A cost-benefit analysis further demonstrates that, overall, the increase in patient benefits cannot overcompensate the additional costs associated with pay-for-performance. Moreover, our analysis of individual data reveals different types of responses to pay-for-performance incentives. We find some indication that pay-forperformance might crowd out the intrinsic motivation to care for patients. These insights help to understand the effects caused by introducing pay-for-performance schemes.

Reputation and Mechanism Choice in Procurement Auctions - An Experiment

We experimentally study the role of reputation in procurement using two common mechanisms: price-based and buyer-determined auctions. While buyers are bound to buy from the lowest bidder in price-based auctions, they can choose between bidders in buyer-determined auctions. Only in the latter buyers can consider the reputation of bidders. We find that bidders supply higher quality in buyer-determined auctions leading to higher market efficiencies in these auctions. Accordingly, buyers prefer the buyer-determined auction over the price-based auction, while only half of the bidders do so. A more detailed analysis of buyers’ and bidders’ behavior and profits provides insights into their mechanism choice.

The dynamics of behavior in modified dictator games

We investigate the dynamics of individual pro-social behavior over time. The dynamics are tested by running the same experiment with the same subjects at several points in time. To exclude learning and reputation building, we employ non-strategic decision tasks and a sequential prisoners-dilemma as a control treatment. In the first wave, pro-social concerns explain a high share of individual decisions. Pro-social decisions decrease over time, however. In the final wave, most decisions can be accounted for by assuming pure selfishness. Stable behavior in the sense that subjects stick to their decisions over time is observed predominantly for purely selfish subjects. We offer two explanation for our results: diminishing experimenter demand effects and moral self-licensing.

How do coalitions get built? Evidence from an extensive form coalition game with and without communication

In the laboratory, we investigate a non-cooperative three-person coalition game with externalities and the opportunity to extend existing coalitions. One bargainer, the builder, can propose and build a coalition over two stages. We examine the hypothesis that both absolute and relative payoffs affect the coalition formation process (and outcome). We observe many inefficient two-person final coalitions, and that the distribution of outcomes is sensitive to the constellation of both absolute and relative payoffs. Relative payoffs appear to be applied more myopically than has been observed in bilateral sequential bargaining games or suggested by social preference models. We hypothesize that the prevalence of two-person coalitions stems from builder’s uncertainty about individual acceptance thresholds. In fact, allowing nonbinding communication among the bargainers increases the prevalence of efficient coalitions. The main implication is that efficient coalition building involves strategies for mitigating the strategic uncertainty inherent in building coalitions.

The More You Know? – Consumption Behavior and the Communication of Economic Information

This paper uses a laboratory experiment to analyze the impact of different types of information on consumption and savings behavior. Based on a buffer stock savings model, three treatment dimensions are used: The amount of information subjects receive about the likelihood of income shocks, whether subjects are informed about other peoples beliefs about these shocks, and the framing of shocks. The results reveal that - even with little information about the random term determining the income shock - consumption decisions are surprisingly close to the optimal consumption path. If at all, more information rather worsens than improves consumption behavior. Nevertheless, in line with the theoretical prediction, observed behavior is robust to the framing and other peoples beliefs about income shocks. Given that actual decisions are signicantly correlated with the optimal consumption amount (and not with easier accessible variables like cash-on-hand) suggests that subjects do not simply use naive heuristics to determine their consumption.