Impact of payment mechanisms on clinicians' behaviour

What is the relative importance of different incentives influencing health professionals’ behaviour?


This research investigates the impact of different provider payment mechanisms on individual decision making. Economic behaviour suggests that the way healthcare providers are paid (e.g. monthly salary, fee-for-service, capitation), can influence their behaviour which in turn can affect both the quality and efficiency of care. However, evidence on these effects is mixed and limited by a number of methodological challenges.

The initial phase of research was conducted under laboratory conditions, using hypothetical clinical scenarios. In subsequent phases of research, a more realistic evaluation of changes introduced under the National Health Insurance Scheme in South Africa will be undertaken.

Project summary


  • For the first phase, researchers have used experimental methods (DCE + experimental games) to isolate the effects of different payment mechanisms.

  • The second phase of the research began in 2016, and will study the effects of a private GP contracting policy in South Africa.