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The Impacts of Physician Payments on Patient Access, Use, and Health

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  • Diane Alexander
  • Molly Schnell

Abstract

We examine how supply-side health insurance generosity affects patient access, use, and health. Exploiting large, exogenous changes in Medicaid reimbursement rates for physicians, we find that increasing payments for new patient office visits reduces reports of providers turning away beneficiaries: closing the gap in payments between Medicaid and private insurers would reduce more than two-thirds of disparities in access among adults and would eliminate such disparities entirely among children. These improvements in access lead to more office visits, better self-reported health, and reduced school absenteeism. While attention is often focused on the role of demand-side insurance generosity, such as program eligibility and patient cost-sharing, our results demonstrate that financial incentives for physicians drive access to care and have important implications for patient health.

Suggested Citation

  • Diane Alexander & Molly Schnell, 2019. "The Impacts of Physician Payments on Patient Access, Use, and Health," NBER Working Papers 26095, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:26095
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    References listed on IDEAS

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    1. Laurence C. Baker & Anne Beeson Royalty, 2000. "Medicaid Policy, Physician Behavior, and Health Care for the Low-Income Population," Journal of Human Resources, University of Wisconsin Press, vol. 35(3), pages 480-502.
    2. Sarah R. Cohodes & Daniel S. Grossman & Samuel A. Kleiner & Michael F. Lovenheim, 2016. "The Effect of Child Health Insurance Access on Schooling: Evidence from Public Insurance Expansions," Journal of Human Resources, University of Wisconsin Press, vol. 51(3), pages 727-759.
    3. David Card & Carlos Dobkin & Nicole Maestas, 2008. "The Impact of Nearly Universal Insurance Coverage on Health Care Utilization: Evidence from Medicare," American Economic Review, American Economic Association, vol. 98(5), pages 2242-2258, December.
    4. Dominic Coey, 2015. "Physicians' financial incentives and treatment choices in heart attack management," Quantitative Economics, Econometric Society, vol. 6(3), pages 703-748, November.
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    More about this item

    JEL classification:

    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • H75 - Public Economics - - State and Local Government; Intergovernmental Relations - - - State and Local Government: Health, Education, and Welfare
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I24 - Health, Education, and Welfare - - Education - - - Education and Inequality

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