Measurement Issue in Paying for Performance.

摘要

This dissertation focuses on a broad class of markets in which it is costly for consumers to observe product-quality information and for economic agents to sign contracts contingent on quality. Rewarding suppliers based on measures of quality performance is a key policy intervention to improve efficiency in such markets. This dissertation provides empirical evidence that measurement matters when policy makers design a pay-for-performance/quality disclosure system in such markets in order to motivate suppliers to improve quality.;The first chapter studies how physicians in China respond to a pay-for-performance scheme intended for reducing drug utilization. There is concern that drugs are overprescribed in China because physicians receive under-the-table drug commissions from drug manufactures. I show that, since drug utilization is measured in percentage levels (i.e., the revenue from drug sales is represented as a percentage of total revenue), the compensation scheme leads to unintended consequences---physicians respond by increasing the utilization of non-drug services, especially for diagnostic tests, rather than decreasing the utilization of drugs. I also find that increased non-drug expenditures are concentrated among insured patients, suggesting that physicians have stronger incentives to act in the patient's interest than in the interest of the third-party payer.;The second and third chapters focus on the industry of fertility clinics and infertility services in the United States. The second chapter examines how changes in information presentation in quality "report cards" affect consumer choice, i.e., the demand-side response to information presentation. The third chapter looks at how these changes motivate clinics to improve quality. I show that after the "singleton success rate" measure is reported more saliently, (a) consumers start to respond to it by being more likely to choose a clinic with a lower "multiple birth rate," and (b) clinics in response transfer fewer embryos.