Khandker RK, Rosenbach ML.
AHSR FHSR Annu Meet Abstr Book. 1994; 11: 44.
Center for Health Economics Research, Waltham, MA 02154.
PROBLEM AND OBJECTIVES: Policymakers are particularly concerned about the effect of physician payment reform on Medicare beneficiaries' access to care. This study examines whether beneficiaries living in areas with payment reductions had any change in utilization and satisfaction after the payment change went into effect. DATA AND METHODS: The study sample is comprised of a two-year (1991-92) panel of 9,251 beneficiaries from the Medicare Current Beneficiary Survey (MCBS). Utilization measures include inpatient admissions and visits to physicians, hospital outpatients and emergency rooms. Satisfaction measures relate to the availability and cost of care. Logistic regression was applied to control for sociodemographic characteristics and health status of the beneficiaries. Dummy variables were used to account for yearly trend and area differences, and interaction terms were used to estimate if trends were different across payment change areas. RESULTS AND CONCLUSIONS: There was an overall (secular) increase in the likelihood of physician, outpatient and emergency visits across all payment change areas. Most fee reduction areas had a slower rate of growth in the use of outpatient department visits relative to areas expecting no fee change. Such reductions were not offset by increases in inpatient admissions. High fee reduction areas had a greater improvement in satisfaction with cost, presumable because beneficiaries experienced a decline in out-of-pocket outlays. IMPLICATIONS FOR AUDIENCE: The short run effects of physician payment change on utilization and satisfaction will be discussed.
Publication Types:
Keywords:
- Data Collection
- Health Expenditures
- Hospitals
- Medicare
- Medicare Payment Advisory Commission
- Physicians
- economics
- hsrmtgs
Other ID:
UI: 102211997
From Meeting Abstracts