title: How do doctors behave when some (but not all) of their patients are in managed care?
abstract: Most physicians today treat a variety of patients within their practices where a variety of insurance arrangements co-exist. In this paper, we propose several theoretical explanations for physician treatment patterns when the patient population is heterogeneous at the practice level. Data from the 1993-1996 National Ambulatory Medical Care Survey (NAMCS) are used to test how practice level managed care penetration affects treatment intensity. Practice composition has strong effects on treatment. Visit duration appears to be constant across patients within a practice, while medications prescribed appear to be converging as managed care penetration increases.
authors.affiliation: Department of Health Policy and Management, Joseph Mailman School of Public Health, Columbia University, New York, NY 10032, USA.
authors.forename: Sherry
authors.initials: S
authors.lastname: Glied
authors.forename: Joshua Graff
authors.initials: JG
authors.lastname: Zivin
mesh_terms: D000553:Ambulatory Care / Q000706:statistics & numerical data; D002204:Capitation Fee; D018588:Fee-for-Service Plans; D019538:Health Care Surveys; D006279:Health Maintenance Organizations / Q000191:economics* / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000191:economics* / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand / Q000191:economics; D006302:Health Services Research; D006801:Humans; D017059:Models, Econometric; D009819:Office Visits / Q000191:economics / Q000706:statistics & numerical data; D011216:Practice Management, Medical / Q000191:economics; D010818:Practice Patterns, Physicians' / Q000191:economics* / Q000706:statistics & numerical data; D012052:Reimbursement, Incentive; D014481:United States