Publications [#210381] of Manoj Mohanan

Papers Submitted

1. with Tisamarie Sherry, Sebastian Bauhoff, Paying for Performance when Healthcare Production is Multi-dimensional: The Impact of Rwanda's National Program on Rewarded Services, Heterogeneity, and Multi-tasking, Economic Research Initiatives at Duke (ERID) Working Paper No. 136, vol. http://ssrn.com/abstract=2170393 (2013)
   (last updated on 2013/10/15)

   Abstract:
   Performance-based contracting based on inputs is particularly challenging in complex settings such as health care, where issues such as joint production, multiple agents in production, and market failures compound the critical contracting concern of multitasking. We analyze the impacts of Rwanda’s national pay-for-performance (P4P) program, where health care facilities were offered performance bonuses based on process measures of health care quality. Using two waves of data from the Rwanda Demographic and Health Surveys, collected before and after the randomized roll-out of P4P, in a difference-in-differences analysis we find that the P4P program improved some rewarded services, had weakly positive impacts on several unrewarded services, and had no impact on health outcomes. We find no evidence of multitasking, and find mixed effects of the program by baseline levels of quality, with most of the improvements seen in the middle quality tier.