title: Quality target negotiation in health care: evidence from the English NHS.
abstract: We examine how public sector third-party purchasers and hospitals negotiate quality targets when a fixed proportion of hospital revenue is required to be linked to quality. We develop a bargaining model linking the number of quality targets to purchaser and hospital characteristics. Using data extracted from 153 contracts for acute hospital services in England in 2010/2011, we find that the number of quality targets is associated with the purchaser's population health and its budget, the hospital type, whether the purchaser delegated negotiation to an agency, and the quality targets imposed by the supervising regional health authority.
authors.affiliation: Manchester Centre for Health Economics, University of Manchester, Manchester, UK.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Fichera
authors.affiliation: Centre for Health Economics, University of York, York, UK.
authors.forename: Hugh
authors.initials: H
authors.lastname: Gravelle
authors.affiliation: Economics, School of Social Sciences, University of Manchester, Manchester, UK. mario.pezzino@manchester.ac.uk.
authors.forename: Mario
authors.initials: M
authors.lastname: Pezzino
authors.affiliation: Manchester Centre for Health Economics, University of Manchester, Manchester, UK.
authors.forename: Matt
authors.initials: M
authors.lastname: Sutton
mesh_terms: D004739:England; D006739:Hospital Administration / Q000191:economics*; D006801:Humans; D017059:Models, Econometric; D017008:Negotiating; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care / Q000191:economics / Q000458:organization & administration*; D012052:Reimbursement, Incentive / Q000191:economics / Q000458:organization & administration*; D013222:State Medicine / Q000191:economics / Q000458:organization & administration*
keywords: Contracts; Financial incentives; Hospitals; Nash bargaining; Pay for performance; Quality