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CINCH - Health Economics Research Center

New CINCH working paper


A new working paper has been added to the CINCH working paper series: “Physicians' altruism in incentives contracts: Medicare's quality race” by Galina Besstremyannaya and Sergei Golovan.

Abstract: The paper analyzes the impact of physicians' altruism and motivation on the outcomes of pay-for-performance schemes in healthcare, where a fixed price contract on quantity is supplemented with a relative performance contract on quality. Our theoretical model forecasts crowding out of most altruistic types. In an empirical application to the Medicare's nationwide natural experiment with a relative performance contract on quality for acute inpatient care since 2013, we observe the proof of this prediction. Namely, the quality dimensions, which are linked to patient's benefit, demonstrate higher deterioration among top-performing hospitals than other incentivized dimensions.


See all working papers.

Essen Health Economics Seminar @ CINCH Essen


On Monday, April 15 2019, 14:00 - 15:30, Tommaso Reggiani (Masaryk Universtiy) will present:

“Should I tell you / or should I not?” The (neutral) effect of transparency on information disclosure nudge: The case of organ donations in Germany 

With the increasing popularity and application of the nudging concept, several ethical objections against it have also emerged due to its subtle architecture. In order to contribute to the debate, this paper examines nudging in the light of transparency.

A transparent nudge is when the citizen being nudged knows the intention behind it and the means adopted to pursue the nudging object. A non-transparent nudge works in a way that the citizen cannot reconstruct the object of the intervention and the means by which the behavioral change is pursued.

Wide - philosophical - consent claims how nudging can only be regarded as ethically acceptable when the nudge is transparent (Fischer & Lotz 2014; Sunstein 2015). Hausman & Welch (2010) demand for nudging transparency, even if it potentially undercuts the effectiveness of the nudge. However, empirical research on nudging often shies away from incorporating explicit transparency.

We design a survey-experiment to examine whether transparency has negative impacts on nudging effectiveness in its configuration of information disclosure nudging (Loewenstein et al. 2014; Wisdom et al. 2010). In partnership with the German Federal Centre for Health (BZgA), we address the very salient and relevant case of the voluntary participation in the German organ donation initiative. We do not find evidence that transparency inhibits the effectiveness of information disclosure nudges. Our finding supports the policy-relevant claim that information disclosure nudges can be transparent and yet effective, reconciling at the same time philosophical and practical issues.

This result is in line with recent findings by Bruns et al. (2016): In a lab experiment, focusing on default nudge applied to contributions to carbon emission reduction, they do not find evidence that transparency inhibits the effectiveness of a default nudging strategy. Similarly, Loewenstein et al.(2015) testing the interaction between transparency and defaults, get to similar conclusions according to results from an online-study focused on health-care related choices.

Room: WST-A.02.04, Weststadttürme Berliner Platz 6-8, Essen

To find more on upcoming seminars, click here.