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The treadmill effect in a fixed budget system

机译:固定预算系统中的跑步机效应

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We examine the interaction in the market for physician services when the total budget for reimbursement is fixed. Physicians obtain points for the services they render. At the end of the period the budget is divided by the sum of all points submitted, which determines the price per point. We show that this retrospective payment system involves - compared to a fee-for-service remuneration system - a severe coordination problem, which potentially leads to the "treadmill effect". We argue that when market entry is possible, a budget can be efficiency enhancing, if in addition a price floor is used.
机译:当报销的总预算是固定的时,我们将检查医师服务市场中的相互作用。医生为其提供的服务获取积分。在期末,将预算除以提交的所有积分的总和,从而确定每积分的价格。我们证明,与按服务付费的薪酬系统相比,这种追溯式支付系统涉及一个严重的协调问题,这有可能导致“跑步机效应”。我们认为,如果有可能进入市场,则可以使用额外的底价来提高预算效率。

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