Advanced Search
MyIDEAS: Login

Medicaid physician fees and the quality of medical care of Medicaid patients in the USA

Contents:

Author Info

  • Sandra Decker

    ()

Registered author(s):

    Abstract

    When enacted in 1965, the original Medicaid legislation sought to finance access to mainstream medical care for the poor. I use data on visits to office-based physicians from the National Ambulatory Medical Care Survey in four years—1989, 1993, 1998 and 2003—to test the extent to which this goal has been achieved. Specifically, I test whether this goal has been achieved more in states that pay higher fees to physicians who treat Medicaid patients compared to states that pay lower fees. By comparing the treatment of Medicaid patients to that of privately-insured patients and by using state fixed effects, I am able to estimate the effects of changes in the generosity of Medicaid physician payment within a state on changes in access to care for Medicaid patients, therefore separating Medicaid’s effect on access to health care from any correlation between the Medicaid fee and other attributes of the state in which a patient lives. Using this method, I examine the effect of Medicaid fees on whether or not an office-based physician accepts Medicaid patients, on the fraction of a physician’s practice that is accounted for by Medicaid, and on the length of visit times with physicians. Results imply that higher Medicaid fees increase the number of private physicians, especially in medical and surgical specialties, who see Medicaid patients. Higher fees also lead to visit times with physicians that are more comparable to visit times with private pay patients. Copyright Springer Science+Business Media, LLC 2007

    Download Info

    If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
    File URL: http://hdl.handle.net/10.1007/s11150-007-9000-7
    Download Restriction: Access to full text is restricted to subscribers.

    As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.

    Bibliographic Info

    Article provided by Springer in its journal Review of Economics of the Household.

    Volume (Year): 5 (2007)
    Issue (Month): 1 (March)
    Pages: 95-112

    as in new window
    Handle: RePEc:kap:reveho:v:5:y:2007:i:1:p:95-112

    Contact details of provider:
    Web page: http://www.springerlink.com/link.asp?id=109451

    Related research

    Keywords: Medicaid; Physician care; Duration of visit; I18;

    Find related papers by JEL classification:

    References

    References listed on IDEAS
    Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
    as in new window
    1. Gruber, Jon & Kim, John & Mayzlin, Dina, 1999. "Physician fees and procedure intensity: the case of cesarean delivery," Journal of Health Economics, Elsevier, vol. 18(4), pages 473-490, August.
    2. McGuire, Thomas G. & Pauly, Mark V., 1991. "Physician response to fee changes with multiple payers," Journal of Health Economics, Elsevier, vol. 10(4), pages 385-410.
    3. Glied, Sherry & Zivin, Joshua Graff, 2002. "How do doctors behave when some (but not all) of their patients are in managed care?," Journal of Health Economics, Elsevier, vol. 21(2), pages 337-353, March.
    4. Thomas G. McGuire & Mark V. Pauly, 1991. "Physician Response to Fee Changes with Multiple Payers," Papers 0015, Boston University - Industry Studies Programme.
    5. Long, Stephen H. & Settle, Russell F. & Stuart, Bruce C., 1986. "Reimbursement and access to physicians' services under Medicaid," Journal of Health Economics, Elsevier, vol. 5(3), pages 235-251, September.
    6. Mark H. Showalter, 1997. "Physicians' Cost Shifting Behavior: Medicaid Versus Other Patients," Contemporary Economic Policy, Western Economic Association International, vol. 15(2), pages 74-84, 04.
    7. Gray, Bradley, 2001. "Do Medicaid physician fees for prenatal services affect birth outcomes?," Journal of Health Economics, Elsevier, vol. 20(4), pages 571-590, July.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as in new window

    Cited by:
    1. Koch, Thomas G., 2013. "Using RD design to understand heterogeneity in health insurance crowd-out," Journal of Health Economics, Elsevier, vol. 32(3), pages 599-611.
    2. Robert Town & Roger Feldman & John Kralewski, 2011. "Market power and contract form: evidence from physician group practices," International Journal of Health Care Finance and Economics, Springer, vol. 11(2), pages 115-132, June.
    3. de la Mata, D;, 2011. "The Effect of Medicaid on Children's Health: A Regression Discontinuity Approach," Health, Econometrics and Data Group (HEDG) Working Papers 11/16, HEDG, c/o Department of Economics, University of York.
    4. Youjin Hahn, 2012. "The Effect of Medicaid Physician Fees on Take-up of Public Health Insurance among Children in Poverty," Development Research Unit Working Paper Series 29-12, Monash University, Department of Economics.
    5. Seth Freedman & Haizhen Lin & Kosali Simon, 2012. "Public Health Insurance Expansions and Hospital Technology Adoption," Working Papers 2012-08, Indiana University, Kelley School of Business, Department of Business Economics and Public Policy.
    6. Johar, Meliyanni, 2010. "The effect of a public health card program on the supply of health care," Social Science & Medicine, Elsevier, vol. 70(10), pages 1527-1535, May.
    7. Christopher Brunt & Gail Jensen, 2010. "Medicare Part B reimbursement and the perceived quality of physician care," International Journal of Health Care Finance and Economics, Springer, vol. 10(2), pages 149-170, June.
    8. Christopher Brunt & Gail Jensen, 2013. "Medicare payment generosity and access to care," Journal of Regulatory Economics, Springer, vol. 44(2), pages 215-236, October.
    9. Diane Alexander, 2013. "Does Physician Compensation Impact Procedure Choice and Patient Health?," Working Papers 1475, Princeton University, Woodrow Wilson School of Public and International Affairs, Center for Health and Wellbeing..

    Lists

    This item is not listed on Wikipedia, on a reading list or among the top items on IDEAS.

    Statistics

    Access and download statistics

    Corrections

    When requesting a correction, please mention this item's handle: RePEc:kap:reveho:v:5:y:2007:i:1:p:95-112. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Guenther Eichhorn) or (Christopher F. Baum).

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If references are entirely missing, you can add them using this form.

    If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.