FFS vs. Capitation Reimbursement: Responses by Physicians and Medical Students

How do people respond to financial incentives?  In the medical world, physicians often are paid fee-for-service (FFS) or capitation.  Physicians receiving FFS reimbursement receive additional compensation for each additional service they do.  For instance, physicians under FFS receive twice as much compensation for 2 office visits as they would for 1 office visit.  On the other hand,…

Do doctors tailor the care they provide based on the patient’s health plan?

Many studies (including my own) have shown that physicians paid via capitation  perform fewer services than those paid via fee-for-service (FFS).  In the current health care world, however, most physicians treat patients from a variety of different insurance systems (notable exceptions are doctors working at Kaiser and the VA). Two important research questions come to…

How to pay doctors: As a Merchant or a Guardian?

The book Systems of Survival (review) describes two moral structures: commerce and guardianship.  Jane Jacobs describes the ethics of Commerce as a moral syndrome equal, antagonistic, and complementary to the ethics of politics, or Guardianship.  Commerce provides the economic engine and the ethical framework for trade, technological advance, and individual rights that combine to make governments…