In the Shadow of a Giant: Medicare's Influence on Private Physician Payments

• 成果类型: Article
• 署名作者: Clemens, Jeffrey; Gottlieb, Joshua D.
• 署名单位: University of California System; University of California San Diego; National Bureau of Economic Research; University of British Columbia
• 刊物名称: JOURNAL OF POLITICAL ECONOMY
• ISSN/ISSBN: 0022-3808
• 发表日期: 2017
• 页码: 1-39
• 关键词: health-care; Managed care; market-size; COST-SHIFT; COMPETITION; networks; industry; INNOVATION; coverage; prices

摘要

We analyze Medicare's influence on private insurers' payments for physicians' services. Using a large administrative change in reimbursements for surgical versus medical care, we find that private prices follow Medicare's lead. A $1.00 increase in Medicare's fees increases corresponding private prices by $1.16. A second set of Medicare fee changes, which generates area-specific payment shocks, has a similar effect on private reimbursements. Medicare's influence is strongest in areas with concentrated insurers and competitive physician markets, consistent with insurer-doctor bargaining. By echoing Medicare's pricing changes, these payment spillovers amplify Medicare's impact on specialty choice and other welfare-relevant aspects of physician practices.