Do Physicians Warm Up to Higher Medicare Prices? Evidence from Alaska

• 成果类型: Article
• 署名作者: Chen, Alice J.; Munnich, Elizabeth L.; Parente, Stephen T.; Richards, Michael R.
• 署名单位: University of Southern California; University of Louisville; University of Minnesota System; University of Minnesota Twin Cities; University of Minnesota System; University of Minnesota Twin Cities; University of Minnesota System; University of Minnesota Twin Cities; Baylor University
• 刊物名称: JOURNAL OF POLICY ANALYSIS AND MANAGEMENT
• ISSN/ISSBN: 1520-6965
• DOI: 10.1002/pam.22344
• 发表日期: 2022
• 页码: 394-+
• 关键词: health-service-corps; payment reductions; volume responses; fee schedule; IMPACT; care; access; PRODUCTIVITY; intensity; number

摘要

Medicare is a roughly $700 billion public program, with physician payments representing one of its largest expenditures. Medicare's prices are also administratively set, which leaves the structure of payment changes subject to a political process that may introduce idiosyncratic features and even perverse incentives. At the same time, physician responses to changes in Medicare reimbursements are likely to vary according to the policy's duration, scope, and size. We study a setting where broad federal laws contained specific provisions that financially benefit a narrow group: Alaskan physicians. The geographically targeted payment reforms were also unique along key dimensions. Using difference-in-differences strategies, we find that large, temporary price changes increase spending but elicit no detectable supply response. Conversely, generous and permanent price shocks induce greater service flows but not uniformly across specialties. Our findings suggest that Congress may engage in fiscally inefficient Medicare spending to accomplish other legislative objectives. (c) 2021 by the Association for Public Policy Analysis and Management