IDEAS home Printed from https://ideas.repec.org/a/nse/ecosta/ecostat_2021_524d_3.html

The Ban on Extra-Fees for Beneficiaries of the CMU-C Health Cover: What Consequences for Physicians and Dentists in Private Practice?

Author

Listed:
  • Brigitte Dormont
  • Cécile Gayet

Abstract

[eng] Whilst it is forbidden to charge patients with CMU-C health cover fees in excess of the reimbursable regulated fee (or extra fees), so as to make their access to care easier, field experiment studies report discrimination against the latter by physicians. This issue is approached here from the angle of healthcare supply, using four waves of longitudinal administrative data on physicians in private practice between 2005 and 2014. We examine whether this ban on excess fees for CMU-C beneficiaries, i.e. charging them fees in excess of the standard social security-negotiated fees agreed under the public health insurance scheme, generates a real financial constraint for Sector 2 physicians (those who charge extra-fees) and dentists in private practice. Estimates show a significant drop in the average extra-fees per procedure when physicians accept more CMU-C patients in their practice. Even if costs are transferred (cost-shifting), with other patients being charged higher extra-fees, this is not enough to offset the financial impact. However, this restriction does not have a negative impact on total fees for Sector 2 specialists, general practitioners and dentists, as they increase their volume of activity at the same time.

Suggested Citation

  • Brigitte Dormont & Cécile Gayet, 2021. "The Ban on Extra-Fees for Beneficiaries of the CMU-C Health Cover: What Consequences for Physicians and Dentists in Private Practice?," Economie et Statistique / Economics and Statistics, Institut National de la Statistique et des Etudes Economiques (INSEE), issue 524-525, pages 31-47.
    • Handle: RePEc:nse:ecosta:ecostat_2021_524d_3
    DOI: https://doi.org/10.24187/ecostat.2021.524d.2046
    as

    Download full text from publisher

    File URL: https://www.insee.fr/en/statistiques/fichier/5396132/03_ES524-525_Dormont-Gayet_EN.pdf
    Download Restriction: no
    File URL: https://libkey.io/https://doi.org/10.24187/ecostat.2021.524d.2046?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Frank Sloan & Janet Mitchell & Jerry Cromwell, 1978. "Physician Participation in State Medicaid Programs," NBER Chapters, in: The Economics of Physician and Patient Behavior, pages 211-245, National Bureau of Economic Research, Inc.
    2. Olivier Chanel & Alain Paraponaris & Christel Protière & Bruno Ventelou, 2017. "Take the Money and Run? Hypothetical Fee Variations and French GPs’ Labour Supply," Revue économique, Presses de Sciences-Po, vol. 68(3), pages 357-377.
    3. 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, April.
    4. Diane Alexander & Molly Schnell, 2024. "The Impacts of Physician Payments on Patient Access, Use, and Health," American Economic Journal: Applied Economics, American Economic Association, vol. 16(3), pages 142-177, July.
    5. repec:dau:papers:123456789/9221 is not listed on IDEAS
    6. repec:dau:papers:123456789/9219 is not listed on IDEAS
    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


    Cited by:

    1. Kingsada, Aimée, 2024. "Can financial incentives improve access to care? Evidence from a French experiment on specialist physicians," Social Science & Medicine, Elsevier, vol. 352(C).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Christopher Brunt & Gail Jensen, 2013. "Medicare payment generosity and access to care," Journal of Regulatory Economics, Springer, vol. 44(2), pages 215-236, October.
    2. Sandra Decker, 2007. "Medicaid physician fees and the quality of medical care of Medicaid patients in the USA," Review of Economics of the Household, Springer, vol. 5(1), pages 95-112, March.
    3. Dillender, Marcus & Jinks, Lu & Lo Sasso, Anthony T., 2023. "When (and why) providers do not respond to changes in reimbursement rates," Journal of Public Economics, Elsevier, vol. 217(C).
    4. Wagner, Kathryn L., 2016. "Shock, but no shift: Hospitals' responses to changes in patient insurance mix," Journal of Health Economics, Elsevier, vol. 49(C), pages 46-58.
    5. Sonchak, Lyudmyla, 2015. "Medicaid reimbursement, prenatal care and infant health," Journal of Health Economics, Elsevier, vol. 44(C), pages 10-24.
    6. Abe Dunn & Joshua D Gottlieb & Adam Hale Shapiro & Daniel J Sonnenstuhl & Pietro Tebaldi, 2024. "A Denial a Day Keeps the Doctor Away," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 139(1), pages 187-233.
    7. Thomas Buchmueller & John C. Ham & Lara D. Shore-Sheppard, 2015. "The Medicaid Program," NBER Chapters, in: Economics of Means-Tested Transfer Programs in the United States, Volume 1, pages 21-136, National Bureau of Economic Research, Inc.
    8. Cadena, Brian C. & Smith, Austin C., 2022. "Performance pay, productivity, and strategic opt-out: Evidence from a community health center," Journal of Public Economics, Elsevier, vol. 206(C).
    9. Frank A. Sloan, 1984. "State Discretion in Ftderal Categorical Assistance Programs: the Case of Medicaid," Public Finance Review, , vol. 12(3), pages 321-346, July.
    10. repec:mpr:mprres:3323 is not listed on IDEAS
    11. Gilbert R. Ghez & Michael Grossman, 1979. "Preventive Care, Care for Children and National Health Insurance," NBER Working Papers 0417, National Bureau of Economic Research, Inc.
    12. Hamersma, Sarah & Maclean, Johanna Catherine, 2021. "Do expansions in adolescent access to public insurance affect the decisions of substance use disorder treatment providers?," Journal of Health Economics, Elsevier, vol. 76(C).
    13. Nicholas Benson & Jose Joaquin Lopez, 2024. "Surgeons' response to reimbursement changes for alternative procedures: Evidence from spine fusion in the U.S," Contemporary Economic Policy, Western Economic Association International, vol. 42(1), pages 41-55, January.
    14. Jonathan Gruber & Kathleen Adams & Joseph P. Newhouse, 1997. "Physician Fee Policy and Medicaid Program Costs," Journal of Human Resources, University of Wisconsin Press, vol. 32(4), pages 611-634.
    15. Barili, Emilia & Bertoli, Paola & Grembi, Veronica, 2021. "Neighborhoods, networks, and delivery methods," Journal of Health Economics, Elsevier, vol. 80(C).
    16. Johanna Catherine Maclean & Brendan Saloner, 2019. "The Effect of Public Insurance Expansions on Substance Use Disorder Treatment: Evidence from the Affordable Care Act," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 38(2), pages 366-393, March.
    17. Jeffrey Clemens & Jonathan M. Leganza & Alex Masucci, 2026. "Plugging gaps in payment systems: Evidence from the take‐up of new Medicare billing codes," Contemporary Economic Policy, Western Economic Association International, vol. 44(1), pages 105-130, January.
    18. Martin B. Hackmann & Juan S. Rojas & Nicolas R. Ziebarth, 2025. "Creative Financing and Public Moral Hazard: Evidence from Medicaid and the Nursing Home Industry," NBER Working Papers 34118, National Bureau of Economic Research, Inc.
    19. Walker, Brigham & Wisniewski, Janna & Tinkler, Sarah & Stano, Miron & Sharma, Rajiv, 2024. "Patient preferences and physician availability based on physician nativity and international medical school attendance," Journal of Economic Behavior & Organization, Elsevier, vol. 228(C).
    20. Jie Ma & Kosali I. Simon, 2020. "Heterogeneous Effects Of Health Insurance On Birth Related Outcomes: Unpacking Compositional Vs. Direct Changes," NBER Working Papers 27728, National Bureau of Economic Research, Inc.
    21. Amelia Bond & William Pajerowski & Daniel Polsky & Michael R. Richards, 2017. "Market environment and Medicaid acceptance: What influences the access gap?," Health Economics, John Wiley & Sons, Ltd., vol. 26(12), pages 1759-1766, December.

    More about this item

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • C23 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Models with Panel Data; Spatio-temporal Models

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:nse:ecosta:ecostat_2021_524d_3. See general information about how to correct material in RePEc.

    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 CitEc recognized a bibliographic reference but did not link an item in RePEc 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 RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Veronique Egloff (email available below). General contact details of provider: https://edirc.repec.org/data/inseefr.html .

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

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.