Raising the Stakes: Physician Facility Investments and Provider Agency
研究发现，医生投资日间手术中心等设施后，其私人利益与患者利益趋于一致，促使他们减少高成本医疗选择，使每位医生的Medicare支出降低10%至40%，且未发现不良行为。
Principal-agent problems often extend beyond what can be directly addressed through conventional incentive arrangements. We examine a context where physicians are likely under-incentivized to minimize total medical costs until their private financial interests align with those of patients. Leveraging novel data on physician ownership of ambulatory surgery centers——that is, same-day facilities——we show that these equity holdings cause a substitution away from higher cost, rival settings that lowers Medicare spending by 10–40 percent per physician. We find no clear evidence of perverse behavior following these investments. Instead, our findings demonstrate how entrepreneurial activity can indirectly limit principal-agent problems and improve efficiency.