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Medicare Balance Billing Restrictions: Impacts on Physicians and Beneficiaries

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  • Robin McKnight

    ()
    (University of Oregon Economics Department and NBER)

Abstract

Recent publicity about “concierge physicians” has raised concerns about the potential adverse effects of allowing physicians to bill their patients for fees that are above normal copayments and insurance reimbursements. In particular, consumers who are unable to afford the additional costs of such physicians are concerned that their access to highquality medical care could be compromised. Such concerns in the context of Medicare led states and the federal government, beginning in the late 1980s, to restrict the ability of physicians to “balance bill” beneficiaries for charges in excess of the copayment and reimbursement amounts approved by Medicare. In this paper, I provide empirical evidence that this policy change resulted in an 8% reduction in out-of-pocket medical expenditures by elderly households. In spite of the change in marginal reimbursement to physicians, however, I find little evidence that the restrictions affected quantity or quality of care.

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Bibliographic Info

Paper provided by University of Oregon Economics Department in its series University of Oregon Economics Department Working Papers with number 2004-13.

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Length: 43
Date of creation: 23 Sep 2004
Date of revision:
Handle: RePEc:ore:uoecwp:2004-13

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Keywords: price controls; Medicare; physician reimbursement;

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  1. Glazer, Jacob & Glazer, Jacob & McGuire, Thomas G., 1993. "Should physicians be permitted to 'balance bill' patients?," Journal of Health Economics, Elsevier, vol. 12(3), pages 239-258, October.
  2. Mitchell, Janet B. & Cromwell, Jerry, 1982. "Physician behavior under the medicare assignment option," Journal of Health Economics, Elsevier, vol. 1(3), pages 245-264, December.
  3. Yelowitz, Aaron S., 2000. "Public policy and health insurance choices of the elderly: evidence from the medicare buy-in program," Journal of Public Economics, Elsevier, vol. 78(3), pages 301-324, November.
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Cited by:
  1. Lecluyse, Ann & Van de Voorde, Carine & De Graeve, Diana & Schokkaert, Erik & Van Ourti, Tom, 2009. "Hospital supplements in Belgium: Price variation and regulation," Health Policy, Elsevier, vol. 92(2-3), pages 276-287, October.
  2. Mathias Kifmann & Florian Scheuer, 2011. "Balance billing: the patients' perspective," Health Economics Review, Springer, vol. 1(1), pages 1-14, December.
  3. Hugh Gravelle & Anthony Scott & Peter Sivey & Jongsay Yong, 2013. "Competition, Prices and Quality in the Market for Physician Consultations," Melbourne Institute Working Paper Series wp2013n23, Melbourne Institute of Applied Economic and Social Research, The University of Melbourne.
  4. 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.
  5. Hiroyuki Kawaguchi, 2012. "Unique mixtures of public and private funding in Japan - The ban on billing for mixed medical care service -," Public Policy Review, Policy Research Institute, Ministry of Finance Japan, vol. 8(2), pages 145-170, July.

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