Resumen

A well-documented feature of technological change is its remarkably slow diffusion and one reason could be that adopting productive innovations can be costly above and beyond acquisition expenditures. The medical industry, worldwide, has been characterized by a slow adoption of better quality care practices. This paper uses a randomized field experiment to examine the effects of temporary financial incentives paid to medical care clinics for the initiation of prenatal care in the first trimester of pregnancy. The rate of early initiation of care was 34% higher in the treatment group than in the control group while the incentives were being paid, and this effect persisted at least 24 months after the incentives ended. We also show that treatment clinics developed novel data driven strategies to identify, locate and encourage likely pregnant women to seek care early. These results are consistent with a model where the temporary incentives enable providers to address the fixed costs of adopting new innovations, and suggest that temporary incentives may be effective at motivating improvements in long run provider performance at a substantially lower cost than permanent incentives.