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IQuaD was funded by the NIHR HTA (project 09/01/45). INTERVAL was funded by the NIHR HTA (project 06/35/99). No additional funding was obtained to conduct the randomised studies with the trials. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. The Health Services Research Unit is funded by the Chief Scientist Office of the Scottish Government Health and Social Care Directorates. ; Peer reviewed ; Postprint

How can independent physician contractors be motivated to contribute to public service health care? We consider evidence, derived from a natural experiment in the UK publicly funded dental care system, concerning the efficacy of using a contractual mechanism that provides explicit rewards for increased service provision against the alternative of offering an employment-like relationship. We find that dentists who were moved from quasi-employment to an activity-based incentive contract increased their activity in the publicly funded service by 26%. We also find and quantify evidence of considerable variation between suppliers, which suggests that factors such as an individual's intrinsic motivation, professional standards, and preferences are important moderators of financial incentives. Adapted from the source document.

Acknowledgments We thank all of the respondents to our survey who took the time to share their opinions and preferences with us, as well as all members of the IQuaD study team who provided input, advice, and comments on draft versions of the survey. Open Access via the Jisc Sage Open Access Agreement Funder - national institute for health research 10.13039/501100000272 09/01/45 Funding The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The project was funded by the UK National Institute for Health Research (NIHR) Health Technology Assessment (HTA) Programme (project number: 09/01/45). The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the Department of Health or the funders that provide institutional support for the authors of this report. The Health Economics Research Unit and the Health Services Research Unit are funded by the Chief Scientist Office of the Scottish Government Health and Social Care Directorates ; Peer reviewed ; Publisher PDF