Does managed care mean more hassle for physicians?
Using the results of a 1995 nationally representative survey of physicians, this paper examines the relationship between exposure to managed care and resources expended by physicians on administrative and insurance matters. Our measures of managed care exposure are the degree to which a physician experiences a variety of managed care techniques (i.e., utilization review, capitation payment, restricted panels, gatekeepers, discounted fees, compensation links to utilization measures, profiling, protocols, and salary payment). Physicians report expending, on average, three hours per week on insurance-related matters and 4.8 hours per week on administration. Although managed care techniques affect administrative and insurance-related burdens, the direction of that effect varies according to the form that managed care exposure takes. With the exception of being salaried, none of our variables has an economically significant effect on physicians' administrative/insurance burdens, even at the outer-most edge of the 95% confidence interval. Overall, our findings contradict the widely held notion that managed care dramatically raises the administrative and insurance burden of physicians.
Remler
D K
DK
Division of Health Policy and Management, Joseph L. Mailman School of Public Health, Columbia University, New York, NY 10032, USA.
Gray
B M
BM
Newhouse
J P
JP
D001291:Attitude of Health Personnel; D018588:Fee-for-Service Plans / Q000458:organization & administration; D006302:Health Services Research; D006801:Humans; D007587:Job Description; D007588:Job Satisfaction; D016018:Least-Squares Analysis; D008329:Managed Care Programs / Q000458:organization & administration*; D017059:Models, Econometric; D009817:Office Management / Q000458:organization & administration*; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration; D010820:Physicians / Q000458:organization & administration* / Q000523:psychology; D012017:Referral and Consultation / Q000458:organization & administration; D012456:Salaries and Fringe Benefits; D011795:Surveys and Questionnaires; D013996:Time and Motion Studies; D014481:United States; D014600:Utilization Review / Q000458:organization & administration; D016526:Workload