Payment schemes and treatment responses after a demand shock in mental health care
研究了两类心理健康服务提供者在患者数量骤降20%后，是否调整治疗时长以弥补收入损失，发现自雇者受阶梯式按服务收费限制未延长治疗，而受预算约束的机构平均延长了8%的治疗时长，但未改善患者结果。
We study whether two groups of mental health care providers-each paid according to a different payment scheme-adjusted the duration of their patients' treatments after they faced an exogenous 20% drop in the number of patients. For the first group of providers, self-employed providers, we find that they did not increase treatment duration to recoup their income loss. Treatment duration thresholds in the stepwise fee-for-service payment function seem to have prevented these providers to treat patients longer. For the second group of providers, large mental health care institutions who were subject to a budget constraint, we find an average increase in treatment duration of 8%. Prior rationing combined with professional uncertainty can explain this increase. We find suggestive evidence for overtreatment of patients as the longer treatments did not result in better patient outcomes, i.e. better General Assessment of Functioning scores.