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首页> 外文期刊>Journal of law, economics, & organization >Structuring Incentives within Accountable Care Organizations
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Structuring Incentives within Accountable Care Organizations

机译：在责任关怀组织内构建激励机制

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Accountable Care Organizations (ACOs) are new organizations created by the Affordable Care Act to encourage more efficient, integrated care delivery. To promote efficiency, ACOs sign contracts under which they keep a fraction of the savings from keeping costs below target provided they also maintain quality levels. To promote integration and facilitate measurement, ACOs are required to have at least 5000 enrollees and so must coordinate across many providers. We calibrate a model of optimal ACO incentives using proprietary performance measures from a large insurer. Our key finding is that free-riding is a severe problem and causes optimal incentive payments to exceed cost savings unless ACOs simultaneously achieve extremely large efficiency gains. This implies that successful ACOs will likely rely on motivational strategies that amplify the effects of underpowered incentives. These motivational strategies raise important questions about the limits of ACOs as a policy for promoting more efficient, integrated care
机译：问责护理组织（ACO）是由《平价医疗法案》（Affordable Care Act）创建的新组织，旨在鼓励更高效，更全面的护理服务。为了提高效率，ACO签订了合同，只要他们还保持质量水平，他们就可以将成本保持在目标以下，从而节省一部分资金。为了促进集成并促进评估，ACO必须至少有5000名注册者，因此必须在许多提供商之间进行协调。我们使用大型保险公司的专有绩效指标来校准最佳ACO激励模型。我们的主要发现是，搭便车是一个严重的问题，除非ACO同时获得极大的效率收益，否则搭便车的最优奖励金将超过节省的成本。这意味着成功的ACO可能会依靠激励策略来放大动力不足激励的效果。这些激励策略提出了有关ACO的局限性的重要问题，而ACO的局限性是促进更有效，更全面护理的政策

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