The effect of reimbursement on medical decision making: Do physicians alter treatment in response to a managed care incentive?

Journal of Health Economics

Volumn 28, Issue 4, 2009, Pages 902-907

  Melichar, Lori ^a  

^a ROBERT WOOD JOHNSON FOUNDATION   (United States)

Author keywords

Capitation; Incentives; Physician; Reimbursement; Treatment

Indexed keywords

DECISION MAKING; EMPIRICAL ANALYSIS; INCENTIVE; REGRESSION ANALYSIS;

ARTICLE; CAPITATION FEE; HEALTH CARE QUALITY; HEALTH ECONOMICS; HUMAN; MEDICAL DECISION MAKING; PATIENT CARE; PHYSICIAN ATTITUDE; REIMBURSEMENT;

ATTITUDE OF HEALTH PERSONNEL; DECISION MAKING; HUMANS; MANAGED CARE PROGRAMS; PHYSICIAN'S PRACTICE PATTERNS; REGRESSION ANALYSIS; REIMBURSEMENT, INCENTIVE; UNITED STATES;

EID: 70349257720     PISSN: 01676296     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.jhealeco.2009.03.004     Document Type: Article

References (31)

1. Arrow K. Uncertainty and the welfare economics of medical care. American Economic Review 53 5 (1963)
2. Clancy C., and Hillner B. Physicians as gatekeepers: the impact of financial incentives. Archives of Internal Medicine 149 4 (1989)
3. Cooper, P., Simon, K., Vistnes, J., January 2005. What drives health insurance options at the workplace? Evidence from 1997-2002 MEPS employer data. Unpublished paper.
4. Epstein A., Begg C., and McNeil B. The use of ambulatory testing in prepaid and fee-for-service group practices: relation to perceived profitability. New England Journal of Medicine 314 17 (1986)
5. Freund D., and Allen K. Factors affecting physicians' choice to practice in a fee-for-service setting versus and individual practice association. Medical Care 23 6 (1985)
6. Gaynor, M., Rebitzer, J., Taylor, L., 2001. Incentives in HMOs. NBER Working Paper Series, #w8522.
7. Gilchrist V., Stange K., Flocke S., McCord G., and Bourguet C. A Comparison of the National Ambulatory Medical Care Survey (NAMCS) Measurement Approach With Direct Observation of Outpatient Visits. Medical Care 42 3 (2004)
8. Glied S., and Zivin J. How do doctors behave when some (but not all) of their patients are in managed care?. Journal of Health Economics 21 2 (2002)
9. Gold M. The changing US health care system: challenges for responsible public policy. The Millbank Quarterly 77 1 (1999)
10. Gold M. Financial incentives in managed care: current realities and challenges for physicians. Journal of General Internal Medicine 14 Suppl. 1 (1999)
11. Greenfield S., Magotich W., Carneyand M., and Tarlov A. Outcomes of patients with hypertension and non-insulin dependent diabetes mellitus treated by different systems and specialties: results from the medical outcomes study. Journal of the American Medical Association 274 18 (1995)
12. Hadley J., and Mitchell J. Effects of HMO market penetration on physicians' work effort and satisfaction. Health Affairs 16 6 (1997)
13. Kwon S. Structure of financial incentive systems for providers in managed care plans. Medical Care Research and Review 53 2 (1996)
14. Lurie N., Christianson J., Finch M., and Moscovice I. The effects of capitation on health and functional status of the medicaid elderly. Annals of Internal Medicine 120 (1994) Managed Care Fact Sheet
15. MCOL. Managed Care Fact Sheets. http://www.mcareol.com/factshts/factshet.htm (accessed 23.03.2008).
16. Mechanic D., McAlpine D., and Rosenthal M. Are patients' office visits with physicians getting shorter?. New England Journal of Medicine 344 3 (2001)
17. Miller R., and Luft H. Managed care plan performance since 1980: a literature analysis. Journal of the American Medical Association 271 19 (1994)
18. Miller T., and Sage W. Disclosing physician financial incentives. Journal of the American Medical Association 281 15 (1999)
19. Murray J., Greenfield S., Kaplan S., and Yano E. Ambulatory testing for capitation and fee-for-service patients in the same practice setting. Medical Care 30 3 (1992)
20. O'Malley A., Pham H., and Reschovsky J. Predictors of the growing influence of clinical practice guidelines. Journal of General Internal Medicine. 22 6 (2007)
21. Phillips K., Fernyak S., Potosky A., Schauffler H., and Egorin M. Use of preventive services by managed care enrollees: an updated perspective. Health Affairs 19 1 (2000)
22. Remler D., Donelan K., and Blendon R. What do managed care plans do to affect care? Results from a survey of physicians. Inquiry 34 (1997)
23. Retchin S., and Brown B. The quality of care in medicare health maintenance organizations. American Journal of Public Health 80 (1990)
24. Rice N., and Smith P. Capitation and risk adjustment in health care financing: an international progress report. The Milbank Quarterly 79 1 (2001)
25. Robinson J. Theory and practice in the design of physician payment incentives. The Milbank Quarterly 79 2 (2001)
26. Robinson J., Gardner L., and Luft H. Health plan switching in anticipation of increased medical care utilization. Medical Care 31 1 (1993)
27. Simon C., White W., Gamliel S., and Kletke P. The provision of primary care: does managed care make a difference?. Health Affairs 16 6 (1997)
28. Terry K. Capitation on the rise. Medical Economics 76 23 (1999)
29. Tai-Seale M., McGuire T., and Zhang W. Time allocation in primary care office visits. Health Services Research (2007) 1871
30. Tai-Seale M., McGuire T., Colenda C., Rosen D., and Cook M. Two-minute mental health care for elderly patients: inside primary care visits. Journal of the American Geriatrics Society (2007) 1903
31. Udvarhelyi I., Jennison K., Phillips R., and Epstein A. Comparison of the quality of ambulatory care for fee-for-service and prepaid patients. Annals of Internal Medicine 115 (1991)