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Employed for Higher Pay? How Medicare Payment Rules Affect Hospital Employment of Physicians

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  • David Dranove
  • Christopher Ody

Abstract

Hospitals employ an increasing number of physicians and bill for a growing share of outpatient procedures. We exploit a plausibly exogenous increase in Medicare prices for hospital-employed physicians relative to Medicare prices for other physicians to show that payer reimbursement rules explain part of this trend. The shock we study explains 20 percent of the increase in physician employment and 75 percent of the increase in hospital-billed outpatient procedures between 2009 and 2013.

Suggested Citation

  • David Dranove & Christopher Ody, 2019. "Employed for Higher Pay? How Medicare Payment Rules Affect Hospital Employment of Physicians," American Economic Journal: Economic Policy, American Economic Association, vol. 11(4), pages 249-271, November.
    • Handle: RePEc:aea:aejpol:v:11:y:2019:i:4:p:249-71
    Note: DOI: 10.1257/pol.20170020
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    References listed on IDEAS

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    1. Amitabh Chandra & Amy Finkelstein & Adam Sacarny & Chad Syverson, 2016. "Health Care Exceptionalism? Performance and Allocation in the US Health Care Sector," American Economic Review, American Economic Association, vol. 106(8), pages 2110-2144, August.
    2. Rasmusen, Eric B & Ramseyer, J Mark & Wiley, John S, Jr, 1991. "Naked Exclusion," American Economic Review, American Economic Association, vol. 81(5), pages 1137-1145, December.
    3. Leemore S. Dafny, 2005. "How Do Hospitals Respond to Price Changes?," American Economic Review, American Economic Association, vol. 95(5), pages 1525-1547, December.
    4. Michael D. Whinston & Ilya R. Segal, 2000. "Naked Exclusion: Comment," American Economic Review, American Economic Association, vol. 90(1), pages 296-309, March.
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    Cited by:

    1. Richards, Michael R. & Seward, Jonathan A. & Whaley, Christopher M., 2022. "Treatment consolidation after vertical integration: Evidence from outpatient procedure markets," Journal of Health Economics, Elsevier, vol. 81(C).
    2. Martin Gaynor & Kate Ho & Robert J. Town, 2015. "The Industrial Organization of Health-Care Markets," Journal of Economic Literature, American Economic Association, vol. 53(2), pages 235-284, June.
    3. Devlin, Aileen M. & McCormack, Grace, 2023. "Physician responses to Medicare reimbursement rates," Journal of Health Economics, Elsevier, vol. 92(C).
    4. Brady Post & Edward C. Norton & Brent K. Hollenbeck & Andrew M. Ryan, 2022. "Hospital‐physician integration and risk‐coding intensity," Health Economics, John Wiley & Sons, Ltd., vol. 31(7), pages 1423-1437, July.
    5. Andy Ye Yuan & Bernard Black & Timea Viragh & David J. Magid & Qian Luo & Ali Moghtaderi, 2023. "Effect of financial incentives on hospital‐cardiologist integration and cardiac test location," Journal of Empirical Legal Studies, John Wiley & Sons, vol. 20(3), pages 570-608, September.
    6. Richards, Michael R. & Whaley, Christopher M., 2024. "Hospital behavior over the private equity life cycle," Journal of Health Economics, Elsevier, vol. 97(C).
    7. Stephen McCarthy & Damien Sheehan‐Connor, 2022. "The effect of hospital‐physician integration on hospital costs," Health Economics, John Wiley & Sons, Ltd., vol. 31(11), pages 2333-2368, November.
    8. Lin, Haizhen & McCarthy, Ian M. & Richards, Michael, 2021. "Hospital Pricing Following Integration with Physician Practices," Journal of Health Economics, Elsevier, vol. 77(C).

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    More about this item

    JEL classification:

    • G22 - Financial Economics - - Financial Institutions and Services - - - Insurance; Insurance Companies; Actuarial Studies
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • J23 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Labor Demand
    • J31 - Labor and Demographic Economics - - Wages, Compensation, and Labor Costs - - - Wage Level and Structure; Wage Differentials
    • J44 - Labor and Demographic Economics - - Particular Labor Markets - - - Professional Labor Markets and Occupations

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