Information, Loss Framing, and Spillovers in Pay-for-Performance Contracts

Do incentives matter beyond the information conveyed by pay-for-performance contracts? Does loss framing matter? And do incomplete contracts generate spillovers on unincentivized tasks? This study reports on a framed field experiment with 1,363 mat...

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Main Authors:	Bauhoff, Sebastian, Kandpal, Eeshani
Format:	Working Paper
Language:	English
Published:	World Bank, Washington, DC 2021
Subjects:	PAY-FOR-PERFORMANCE CROWDING OUT HEALTH WORKERS MATERNAL AND CHILD HEALTH SERVICES HEALTH SERVICE DELIVERY
Online Access:	http://documents.worldbank.org/curated/en/918691622646942703/Information-Loss-Framing-and-Spillovers-in-Pay-for-Performance-Contracts http://hdl.handle.net/10986/35724

id	okr-10986-35724
recordtype	oai_dc
spelling	okr-10986-357242021-06-11T05:11:28Z Information, Loss Framing, and Spillovers in Pay-for-Performance Contracts Bauhoff, Sebastian Kandpal, Eeshani PAY-FOR-PERFORMANCE CROWDING OUT HEALTH WORKERS MATERNAL AND CHILD HEALTH SERVICES HEALTH SERVICE DELIVERY Do incentives matter beyond the information conveyed by pay-for-performance contracts? Does loss framing matter? And do incomplete contracts generate spillovers on unincentivized tasks? This study reports on a framed field experiment with 1,363 maternity care workers in 691 primary health facilities in Nigeria to answer these questions. Participants were randomized into three study arms—(1) information with a flat participation fee, (2) performance-based rewards, and (3) performance-based penalties. In each arm, participants had to identify correct clinical actions based on the records of hypothetical patients receiving maternity care. Five of fifteen possible actions were incentivized but performance was measured on all fifteen. Compared to information alone, both rewards and penalties increase time on task by 11 percent, correct overall performance by 6 to 8 percent, and directly incentivized performance by 20 percent. Incentives also generate positive spillovers of 14 percent on unincentivized tasks. Loss framing does not affect performance. Results suggest that improving health worker effort by 8 percent would have an impact on neonatal mortality at par with the short run effect of adding a physician to a health facility. Finally, findings show that a small incentive captures most of the impact, implying that incentives work by making information more effective and that pay-for-performance contracts can be made significantly more cost-effective. 2021-06-10T13:53:40Z 2021-06-10T13:53:40Z 2021-06 Working Paper http://documents.worldbank.org/curated/en/918691622646942703/Information-Loss-Framing-and-Spillovers-in-Pay-for-Performance-Contracts http://hdl.handle.net/10986/35724 English Policy Research Working Paper;No. 9687 CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo World Bank World Bank, Washington, DC Publications & Research Publications & Research :: Policy Research Working Paper Africa Africa Western and Central (AFW) Nigeria
repository_type	Digital Repository
institution_category	Foreign Institution
institution	Digital Repositories
building	World Bank Open Knowledge Repository
collection	World Bank
language	English
topic	PAY-FOR-PERFORMANCE CROWDING OUT HEALTH WORKERS MATERNAL AND CHILD HEALTH SERVICES HEALTH SERVICE DELIVERY
spellingShingle	PAY-FOR-PERFORMANCE CROWDING OUT HEALTH WORKERS MATERNAL AND CHILD HEALTH SERVICES HEALTH SERVICE DELIVERY Bauhoff, Sebastian Kandpal, Eeshani Information, Loss Framing, and Spillovers in Pay-for-Performance Contracts
geographic_facet	Africa Africa Western and Central (AFW) Nigeria
relation	Policy Research Working Paper;No. 9687
description	Do incentives matter beyond the information conveyed by pay-for-performance contracts? Does loss framing matter? And do incomplete contracts generate spillovers on unincentivized tasks? This study reports on a framed field experiment with 1,363 maternity care workers in 691 primary health facilities in Nigeria to answer these questions. Participants were randomized into three study arms—(1) information with a flat participation fee, (2) performance-based rewards, and (3) performance-based penalties. In each arm, participants had to identify correct clinical actions based on the records of hypothetical patients receiving maternity care. Five of fifteen possible actions were incentivized but performance was measured on all fifteen. Compared to information alone, both rewards and penalties increase time on task by 11 percent, correct overall performance by 6 to 8 percent, and directly incentivized performance by 20 percent. Incentives also generate positive spillovers of 14 percent on unincentivized tasks. Loss framing does not affect performance. Results suggest that improving health worker effort by 8 percent would have an impact on neonatal mortality at par with the short run effect of adding a physician to a health facility. Finally, findings show that a small incentive captures most of the impact, implying that incentives work by making information more effective and that pay-for-performance contracts can be made significantly more cost-effective.
format	Working Paper
author	Bauhoff, Sebastian Kandpal, Eeshani
author_facet	Bauhoff, Sebastian Kandpal, Eeshani
author_sort	Bauhoff, Sebastian
title	Information, Loss Framing, and Spillovers in Pay-for-Performance Contracts
title_short	Information, Loss Framing, and Spillovers in Pay-for-Performance Contracts
title_full	Information, Loss Framing, and Spillovers in Pay-for-Performance Contracts
title_fullStr	Information, Loss Framing, and Spillovers in Pay-for-Performance Contracts
title_full_unstemmed	Information, Loss Framing, and Spillovers in Pay-for-Performance Contracts
title_sort	information, loss framing, and spillovers in pay-for-performance contracts
publisher	World Bank, Washington, DC
publishDate	2021
url	http://documents.worldbank.org/curated/en/918691622646942703/Information-Loss-Framing-and-Spillovers-in-Pay-for-Performance-Contracts http://hdl.handle.net/10986/35724
_version_	1764483650567536640

Information, Loss Framing, and Spillovers in Pay-for-Performance Contracts

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