Medicaid physician fees and the quality of medical care of Medicaid patients in the USA
AbstractWhen 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
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Bibliographic InfoArticle provided by Springer in its journal Review of Economics of the Household.
Volume (Year): 5 (2007)
Issue (Month): 1 (March)
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Web page: http://www.springerlink.com/link.asp?id=109451
Medicaid; Physician care; Duration of visit; I18;
Find related papers by JEL classification:
- I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
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- 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.
- Sherry Glied & Joshua Zivin, 2000.
"How Do Doctors Behave When Some (But Not All) of Their Patients are in Managed Care?,"
NBER Working Papers
7907, National Bureau of Economic Research, Inc.
- 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.
- 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.
- Thomas G. McGuire & Mark V. Pauly, 1991. "Physician Response to Fee Changes with Multiple Payers," Papers 0015, Boston University - Industry Studies Programme.
- 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.
- 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.
- 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.
- 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.
- Diane Alexander, 2013. "Does Physician Compensation Impact Procedure Choice and Patient Health?," Working Papers ALEXANDER_D_Jul13.pdf, Princeton University, Woodrow Wilson School of Public and International Affairs, Center for Health and Wellbeing..
- 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.
- 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.
- 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.
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