No margin, no mission

health-care organizations and the quest for ethical excellence

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42 min read
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176 pages 2003

About This Book

A substantial body of research investigates the design of incentives in firms, yet less is known about incentives in organizations that hire individuals to perform tasks with positive social spillovers. We conduct a field experiment in which agents hired by a public health organization are randomly allocated to four groups. Agents in the control group receive a standard volunteer contract often offered for this type of task, whereas agents in the three treatment groups receive small financial rewards, large financial rewards, and non-financial rewards, respectively. The analysis yields three main findings. First, non-financial rewards are more effective at eliciting effort than either financial rewards or the volunteer contract. The effect of financial rewards is much smaller and not significantly different from zero except for the poorest agents, for whom the relative value of the reward is higher. Second, contrary to existing laboratory evidence, financial incentives do not appear to crowd out intrinsic motivation in this setting. Third, non-financial rewards elicit effort both by leveraging intrinsic motivation for the cause and by facilitating social comparison among agents. Overall, the findings demonstrate the power of non-financial rewards to motivate agents in settings where there are limits to the use of financial incentives.

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