Objectives
To present the implications of agency theory in microeconomics, augmented by behavioral economics, for different methods of value-based payment in health care; and to derive a set of future research questions and policy recommendations based on that conceptual analysis.

Data Sources
Original literature of agency theory, and secondarily behavioral economics, combined with applied research and empirical evidence on the application of those principles to value-based payment.

Study Design
Conceptual analysis and targeted review of theoretical research and empirical literature relevant to value-based payment in health care.

Principal Findings
Agency theory and secondarily behavioral economics have powerful implications for design of value-based payment in health care. To achieve improved value—better patient experience, clinical quality, health outcomes, and lower costs of care—high-powered incentives should directly target improved care processes, enhanced patient experience, and create achievable benchmarks for improved outcomes. Differing forms of value-based payment (e.g., shared savings and risk, reference pricing, capitation, and bundled payment), coupled with adjunct incentives for quality and efficiency, can be tailored to different market conditions and organizational settings.

Conclusions
Payment contracts that are “incentive compatible”—which directly encourage better care and reduced cost, mitigate gaming, and selectively induce clinically efficient providers to participate—will focus differentially on evidence-based care processes, will right-size and structure incentives to avoid crowd-out of providers’ intrinsic motivation, and will align patient incentives with value. Future research should address the details of putting these and related principles into practice; further, by deploying these insights in payment design, policy makers will improve health care value for patients and purchasers.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/1475-6773.12408

The Theory of Value-Based Payment Incentives and Their Application to Health Care.

An essential element in the pursuit of value-based health care is provider payment reform. This article aims to identify and analyze payment initiatives comprising a specific manifestation of value-based payment reform that can be expected to contribute to value in a broad sense: (a) global base payments combined with (b) explicit quality incentives. We conducted a systematic review of the literature, consulting four scientific bibliographic databases, reference lists, the Internet, and experts. We included and compared 18 initiatives described in 111 articles/documents on key design features and impact on value. The initiatives are heterogeneous regarding the operationalization of the two payment components and associated design features. Main commonalities between initiatives are a strong emphasis on primary care, the use of "virtual" spending targets, and the application of risk adjustment and other risk-mitigating measures. Evaluated initiatives generally show promising results in terms of lower spending growth with equal or improved quality.

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Value-Based Provider Payment Initiatives Combining Global Payments With Explicit Quality Incentives: A Systematic Review

The study analyzes the effects of the determinants of farmer’s adoption of and investment in agrochemicals by collecting primary data from 156 sampled cocoa farmers in the Sefwi-Wiawso Municipality of Ghana. Descriptive statistical technique was employed to analyze demographic and farm-specific characteristics as well as the adoption rate and expenditure on agrochemicals. The findings highlighted the fact that, though a large proportion of farmers in the study area use agrochemicals, the intensity and amount spent to purchase these inputs are quite low. The Tobit regression model was used to identify and quantify the effects of the determinants of farmer’s investment in agrochemicals. The results generally indicate that the sex of the farmer, age of the farmer, household size, educational attainment, mean age of cocoa farms, farm size and farmers previous output are all important variables in explaining farmers decision to invest in agrochemicals. The paper concludes by recommending that strategic policies orienting towards improving the adoption rate as well as targeting farmers who are less likely to invest in agrochemicals is a pressing issue.

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Modelling Farmers Investment in Agrochemicals: The Experience of Smallholder Cocoa Farmers in Ghana

We propose and test the theory of endogenous change in societal institutions based on historical reconstructions of two ancient civilizations, the Indus and Hohokam, in two water-scarce basins, the Indus Basin in the Indian subcontinent and the lower Colorado Basin in the southwestern United States. In our reconstructions, institutions are approximated by the scale of “cooperation”, be it in the form of the extent of trade, sophisticated irrigation networks, a central state or a loosely held state with a common cultural identity. We study changes in institutions brought about by changes in factors like rainfall, population density, and land-use-induced water resource availability, in a proximate manner. These factors either change naturally or are changed by humans; in either case we contend that the changes affect the stability of cooperative structures over time. We relate the quantitative dimensions of water access by ancient populations to the co-evolution of water access and the socioeconomic and sociopolitical organizations. In doing so, we do not claim that water manipulation was the single most significant factor in stimulating social development and complexity – this would be highly reductionist. Nonetheless, we provide a discussion with the aim to enhance our understanding of the complexity of coupled human–hydrological systems. We find that scarcity triggered more complex cooperative arrangements in both Indus and Hohokam societies.

/pdf/endogenous-change-on-cooperation-and-water-availability-in-1yc0r52c5g.pdf

Endogenous change: on cooperation and water availability in two ancient societies

Samuelson kept optimisation-based problems separated from macroeconomic dynamics in his Foundations, where dynamics was defined in terms of difference and differential equations. Despite some criti...

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Paul Samuelson’s ways to macroeconomic dynamics

the structure of economics a mathematical analysis is available in our digital library an online access to it is set as public so you can download it instantly. Our digital library spans in multiple countries, allowing you to get the most less latency time to download any of our books like this one. Merely said, the the structure of economics a mathematical analysis is universally compatible with any devices to read.

Karolin Baecker

Papers

The Structure Of Economics A Mathematical Analysis