CHE Seminar Series: The effect of financial penalties on dentists
Threats of financial penalties have been proposed as alternative ways to obtain the benefits of financial incentives for healthcare providers without committing additional funding. There have been some promising results of such schemes in secondary care. We aim to examine their use in a primary care setting, where dental practices in England that deliver less than 96 percent of the pre-agreed volume of dental care by the end of the financial year must repay the value of undelivered activity in the following financial year. Those delivering 96% or over receive their full income and can provide up to 4% of the undelivered activity in the following financial year. We study the e!ects of this policy on the volume and composition of claims and revenue using monthly data from 7271 unique dental practices between 2016 to 2023. Using an identification strategy akin to a bunching estimator, we find that the policy causes a large increase in dental practices reaching the 96% threshold. To avoid missing the target, practices at risk of the penalty increase the volume of claims by up to 18 percent in the final month of the financial year, with the e!ect strongest for practices just below the threshold. They also alter the composition of claims and revenue; check-ups accounted for the largest increase in volume of claims, but the revenue from the most highly remunerated and invasive treatments comprised the greatest proportion of additional revenue. These results imply a mixed e!ect on welfare, with the threat of penalties increasing supply of care but also likely causing overtreatment.
Speaker profile
Matthew Sutton is Chair in Health Economics at the University of Manchester and Adjunct Professor at Monash University. His research interests include financing and organisation of health care, the healthcare workforce and influences on health and health behaviours. He is a Fellow of the Academy of Medical Sciences, an NIHR Emeritus Senior Investigator and an Associate Editor for Health Economics.
Weekly seminar series
As part of our Centre's vibrant research culture, we host a weekly seminar series. Visiting and invited researchers present current research relating to the economics of health and wellbeing, and the healthcare sector. Visitors are welcome to join these sessions where discussion and debate is encouraged.
For further information on our seminar series, please contact Trong-Anh.Trinh@monash.edu
Event Details
- Date:
- 5 November 2025 at 12:00 pm – 1:00 pm
- Venue:
- Caulfield campus, Building H, level 9, room H9.14
- Categories:
- CHE Seminar; General
Description
Threats of financial penalties have been proposed as alternative ways to obtain the benefits of financial incentives for healthcare providers without committing additional funding. There have been some promising results of such schemes in secondary care. We aim to examine their use in a primary care setting, where dental practices in England that deliver less than 96 percent of the pre-agreed volume of dental care by the end of the financial year must repay the value of undelivered activity in the following financial year. Those delivering 96% or over receive their full income and can provide up to 4% of the undelivered activity in the following financial year. We study the e!ects of this policy on the volume and composition of claims and revenue using monthly data from 7271 unique dental practices between 2016 to 2023. Using an identification strategy akin to a bunching estimator, we find that the policy causes a large increase in dental practices reaching the 96% threshold. To avoid missing the target, practices at risk of the penalty increase the volume of claims by up to 18 percent in the final month of the financial year, with the e!ect strongest for practices just below the threshold. They also alter the composition of claims and revenue; check-ups accounted for the largest increase in volume of claims, but the revenue from the most highly remunerated and invasive treatments comprised the greatest proportion of additional revenue. These results imply a mixed e!ect on welfare, with the threat of penalties increasing supply of care but also likely causing overtreatment.
Speaker profile
Matthew Sutton is Chair in Health Economics at the University of Manchester and Adjunct Professor at Monash University. His research interests include financing and organisation of health care, the healthcare workforce and influences on health and health behaviours. He is a Fellow of the Academy of Medical Sciences, an NIHR Emeritus Senior Investigator and an Associate Editor for Health Economics.
Weekly seminar series
As part of our Centre's vibrant research culture, we host a weekly seminar series. Visiting and invited researchers present current research relating to the economics of health and wellbeing, and the healthcare sector. Visitors are welcome to join these sessions where discussion and debate is encouraged.
For further information on our seminar series, please contact Trong-Anh.Trinh@monash.edu