A game theoretic setting of capitation versus fee-for-service payment systems

Autoři: Allison Koenecke aff001
Působiště autorů: Institute for Computational & Mathematical Engineering, Stanford University, Stanford, California, United States of America aff001
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0223672


We aim to determine whether a game-theoretic model between an insurer and a healthcare practice yields a predictive equilibrium that incentivizes either player to deviate from a fee-for-service to capitation payment system. Using United States data from various primary care surveys, we find that non-extreme equilibria (i.e., shares of patients, or shares of patient visits, seen under a fee-for-service payment system) can be derived from a Stackelberg game if insurers award a non-linear bonus to practices based on performance. Overall, both insurers and practices can be incentivized to embrace capitation payments somewhat, but potentially at the expense of practice performance.

Klíčová slova:

Games – Health economics – Medical doctors – Nurses – Primary care – Quality of care – System stability – Game theory


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Článek vyšel v časopise


2019 Číslo 10