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Physicians on board: An examination of physician financial interests in ASCs using longitudinal data

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  • Yee, Christine A.
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    Abstract

    This paper investigates physician financial interests in ambulatory surgery centers (ASCs) using novel, longitudinal data that identify board members (directors) of ASCs in Florida. Improving on prior research, the estimated models in this paper disentangle physician director selection effects from the causal impact of these financial interests. The data suggest that even prior to their financial interest, physician directors had larger procedure volumes than non-directors. Physician directors also referred more lower-risk patients. On average, ASC board membership led to a 27% increase in a physician's procedure volume and a 16% increase in a physician's colonoscopy volume. Simulations suggest that 5% of the colonoscopies performed in Florida between 1997 and 2004 may have been due to physician ASC board membership. The evidence also suggests that physician directors steered patients from hospitals to their affiliate ASCs. In addition, they referred and/or treated more lower-risk patients as a result of board membership.

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    File URL: http://www.sciencedirect.com/science/article/pii/S0167629611000919
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    Bibliographic Info

    Article provided by Elsevier in its journal Journal of Health Economics.

    Volume (Year): 30 (2011)
    Issue (Month): 5 ()
    Pages: 904-918

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    Handle: RePEc:eee:jhecon:v:30:y:2011:i:5:p:904-918

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    Web page: http://www.elsevier.com/locate/inca/505560

    Related research

    Keywords: Physician ownership; Financial interest; Ambulatory surgery center; Physician behavior; Patient selection;

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    1. Dranove, David & Satterthwaite, Mark A., 2000. "The industrial organization of health care markets," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 20, pages 1093-1139 Elsevier.
    2. McGuire, Thomas G., 2000. "Physician agency," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 9, pages 461-536 Elsevier.
    3. Burns, Lawton R. & Wholey, Douglas R., 1992. "The impact of physician characteristics in conditional choice models for hospital care," Journal of Health Economics, Elsevier, vol. 11(1), pages 43-62, May.
    4. David, Guy & Neuman, Mark D., 2011. "Physician division of labor and patient selection for outpatient procedures," Journal of Health Economics, Elsevier, vol. 30(2), pages 381-391, March.
    5. Jon R. Gabel & Cheryl Fahlman & Ray Kang & Gregory Woznlak & Phil Kletke & Joel W. Hay, 2008. "Where Do I Send Thee? Does Physician-Ownership Affect Referral Patterns to Ambulatory Surgery Centers?," Mathematica Policy Research Reports 6029, Mathematica Policy Research.
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