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The effect of reimbursement on medical decision making: do physicians alter treatment in response to a managed care incentive?
J Health Econ. 2009 Jul; 28(4):902-7.JH

Abstract

The empirical literature that explores whether physicians respond to financial incentives has not definitively answered the question of whether physicians alter their treatment behavior at the margin. Previous research has not been able to distinguish that part of a physician response that uniformly alters treatment of all patients under a physician's care from that which affects some, but not all of a physician's patients. To explore physicians' marginal responses to financial incentives while accounting for the selection of physicians into different financial arrangements where others could not, I use data from a survey of physician visits to isolate the effect that capitation, a form of reimbursement wherein physicians receive zero marginal revenue for a range of physician provided services, has on the care provided by a physician. Fixed effects regression results reveal that physicians spend less time with their capitated patients than with their non-capitated patients.

Authors+Show Affiliations

Robert Wood Johnson Foundation, Route One and College Road East, Princeton, NJ, 08543, USA. lmelichar@rwjf.org

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19395103

Citation

Melichar, Lori. "The Effect of Reimbursement On Medical Decision Making: Do Physicians Alter Treatment in Response to a Managed Care Incentive?" Journal of Health Economics, vol. 28, no. 4, 2009, pp. 902-7.
Melichar L. The effect of reimbursement on medical decision making: do physicians alter treatment in response to a managed care incentive? J Health Econ. 2009;28(4):902-7.
Melichar, L. (2009). The effect of reimbursement on medical decision making: do physicians alter treatment in response to a managed care incentive? Journal of Health Economics, 28(4), 902-7. https://doi.org/10.1016/j.jhealeco.2009.03.004
Melichar L. The Effect of Reimbursement On Medical Decision Making: Do Physicians Alter Treatment in Response to a Managed Care Incentive. J Health Econ. 2009;28(4):902-7. PubMed PMID: 19395103.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effect of reimbursement on medical decision making: do physicians alter treatment in response to a managed care incentive? A1 - Melichar,Lori, Y1 - 2009/03/28/ PY - 2005/04/15/received PY - 2009/02/28/revised PY - 2009/03/05/accepted PY - 2009/4/28/entrez PY - 2009/4/28/pubmed PY - 2010/1/27/medline SP - 902 EP - 7 JF - Journal of health economics JO - J Health Econ VL - 28 IS - 4 N2 - The empirical literature that explores whether physicians respond to financial incentives has not definitively answered the question of whether physicians alter their treatment behavior at the margin. Previous research has not been able to distinguish that part of a physician response that uniformly alters treatment of all patients under a physician's care from that which affects some, but not all of a physician's patients. To explore physicians' marginal responses to financial incentives while accounting for the selection of physicians into different financial arrangements where others could not, I use data from a survey of physician visits to isolate the effect that capitation, a form of reimbursement wherein physicians receive zero marginal revenue for a range of physician provided services, has on the care provided by a physician. Fixed effects regression results reveal that physicians spend less time with their capitated patients than with their non-capitated patients. SN - 0167-6296 UR - https://www.unboundmedicine.com/medline/citation/19395103/The_effect_of_reimbursement_on_medical_decision_making:_do_physicians_alter_treatment_in_response_to_a_managed_care_incentive L2 - https://linkinghub.elsevier.com/retrieve/pii/S0167-6296(09)00036-8 DB - PRIME DP - Unbound Medicine ER -