2026年第38期(总第1182期)

演讲主题：Why Accountable Care Organizations Leave: Risk-Sensitive Participation and Dynamic Payment Design in Medicare’s Shared Savings Program

主讲人：简大伟 美国威斯康辛大学密尔沃基分校助理教授

主持人：关旭 供应链管理与系统工程系主任、教授

活动时间：2026年5月28日（周四）10:00-11:30

活动地址：管院大楼105教室

主讲人简介：

简大伟，美国威斯康辛大学密尔沃基分校Lubar 商学院供应链与运营管理助理教授，在加利福尼亚大学河滨分校取得运营管理博士。他的研究聚焦于激励机制与信息设计理论及其在商业场景中的应用，涵盖供应链管理、医疗运营、运营与营销交叉等领域。他的研究成果已发表于《Management Science》、《Production and Operations Management》。

活动简介：

Medicare’s Shared Savings Program (MSSP) rewards accountable care organizations (ACOs) for reducing spending relative to benchmarks. The 2018 Pathways to Success reform accelerated the transition to two-sided risk, yet savings stagnated, quality did not improve, and participation worsened. We argue this underperformance reflects two interacting design failures: ratchet effects, where current savings tighten future benchmarks and weaken incentives, and risk sensitivity, which discourages ACOs from entering or remaining in risk-bearing contracts. Using an 11-year panel of 1,028 ACOs, we confirm two-sided risk fails to lift performance, and many one-sided ACOs forgo risk-bearing options under volatility. We build and estimate a dynamic structural model to describe the ACOs’ behavior, and propose an optimal policy that combines prospective benchmarks, risk shielding and dynamic risk preference screening. Counterfactuals show the 2018 reform reduced savings, while the optimal design boosts cost reduction by addressing both core flaws, suggesting slower two-sided risk rollout and improved risk-shielded benchmark incentives.