# Healthcare Mechanisms from Policy-as-Code Search under Strategic Provider Response

arXiv: https://arxiv.org/abs/2605.30680 · HTML: https://mlsanity.com/paper/2605.30680/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 11 of its 58 references that are in the map.
- First posted on arXiv 29 May 2026.

## Builds on (most cited first, 11 of 11)

- [Generative Agents: Interactive Simulacra of Human Behavior](https://mlsanity.com/paper/2304.03442/) (2023)
- [AlphaEvolve: A coding agent for scientific and algorithmic discovery](https://mlsanity.com/paper/2506.13131/) (2025)
- [Performative Prediction](https://mlsanity.com/paper/2002.06673/) (2020)
- [Reinforcement Learning in Healthcare: A Survey](https://mlsanity.com/paper/1908.08796/) (2019)
- [Strategic Classification](https://mlsanity.com/paper/1506.06980/) (2015)
- [Categorizing Variants of Goodhart's Law](https://mlsanity.com/paper/1803.04585/) (2018)
- [Strategic Classification from Revealed Preferences](https://mlsanity.com/paper/1710.07887/) (2017)
- [Generative agent-based modeling with actions grounded in physical, social, or digital space using Concordia](https://mlsanity.com/paper/2312.03664/) (2023)
- [Strategic Classification Made Practical](https://mlsanity.com/paper/2103.01826/) (2021)
- [Optimal Auctions through Deep Learning: Advances in Differentiable Economics](https://mlsanity.com/paper/1706.03459/) (2017)
- [LLM Economist: Large Population Models and Mechanism Design in Multi-Agent Generative Simulacra](https://mlsanity.com/paper/2507.15815/) (2025)

## Abstract (arXiv)

Healthcare mechanisms are inseparable from the strategic provider response they induce: existing healthcare AI benchmarks hold this response fixed and so cannot evaluate mechanisms by the equilibrium they produce. We recast hospital mechanism design as program synthesis for language models: typed, inspectable rule programs are executed and scored by Medi-Sim, a multi-agent simulator with five strategic provider channels (coding, selection, delay, effort, triage). An incentive sweep recovers classical health-economics findings as adjacent regimes -- up-coding and low-complexity-patient selection under profit pressure, and Goodhart-style drift where measured performance becomes anti-correlated with true outcomes -- and a single audit lever exposes pressure migration: closing the coding channel more than doubles low-complexity selection. LLM-guided evolutionary code search over the same rule-program space then synthesizes an inspectable mixed-objective program that eliminates up-coding, halves rejection, and retains most of the profit-oriented baseline's funds.