CPGs define medical care production possibility frontiers in that they prescribe the clinical content of care that maximizes the likelihood of successful health outcomes based on medical science, clinical trials, and practitioner consensus. Local CPGs are regularly updated and serve as the basis of training in medical schools and practitioner refresher courses. While the lack of compliance with CPGs may in part reflect a lack of knowledge, evidence shows that practitioners often provide a standard of care well below their level of knowledge of CPGs.<sup>4</sup> In a systematic review of the literature on reasons for non‐compliance of CPGs, Cabana et al. (1999) report that resistance to changing existing practice patterns is one of the most important barriers to CPG adherence. For example, Grol and Grimshaw (2003) surveyed nurses and doctors in the UK about the adoption of new hand hygiene guidelines. Forty‐nine percent responded that resistance to changing old routines was an obstacle to complying with new guidelines.<sup>5</sup> Changing deep‐rooted habits is hard and even small costs of adjustment may inhibit changes in favor of maintaining the status quo, (DellaVigna 2009; Thaler and Sunstein 2009).<sup>6</sup> In these circumstances, temporary incentives may speed adoption by helping to compensate providers for the initial fixed costs of changing their practice pattern routines. This amounts to paying providers a time‐limited per unit incentive for the provision of a component of the CPGs for a specific condition.<sup>7</sup> The use of temporary incentives to overcome organizational inertia in firms is similar in spirit to the use of temporary incentives to change individual and consumer behavior. Firms often use temporary price discounts, such as sales and coupons, to market their products (Blattberg and Neslin 1990; Kirmani and Rao 2000; and Dupas 2014). Discounts encourage individuals to purchase goods that they are not in the habit of buying which in turn allow them to update their beliefs about the product’s benefits. Similarly, temporary incentives have been used to try to help individuals develop better health habits such as exercise and quitting smoking.<sup>8</sup> Recently, temporary incentives have 4 See Das and Hammer (2005); Das and Gertler (2007); Das, Hammer and Leonard (2008); Barber and Gertler (2009); Leonard and Masatu (2010); Gertler and Vermeersch (2012); and Monahan, M. et al. (2015).

5 For more evidence of organizational inertia serving as a barrier to CPG compliance see Grol (1990); Hudak, O’Donnell and Mazyrka (1995); Main, Cohen and DiClemente (1995); and Pathman et al. (1996).

6 We use a different definition of habits than the behavioral economics literature where habits are based on the addiction of models of Becker and Murphy (1988). Instead, we rely on the notions of fast and slow thinking discussed in Kahneman (2012) where tasks performed based on fast thinking become habits.

7 Paying an upfront lump sum amount is another option. However, it may be harder to ensure and verify the actual change in practice patterns. By paying based on actual performance the incentives also include a commitment device for compliance.

8 See for example Volpp et al. (2008); Volpp et al. (2009); Charness and Gneezy (2009); John et al. (2011); Royer et al. (2012); Cawley and Price (2013); and Acland and Levy (2015).

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