title: Operating on commission: analyzing how physician financial incentives affect surgery rates.
abstract: This paper employs a nationally representative, household-based dataset in order to test how the compensation method of both the specialists and the primary care providers affects surgery rates. After controlling for adverse selection, I find that when specialists are paid through a fee-for-system scheme rather than on a capitation basis, surgery rates increase 78%. The impact of primary care physician compensation on surgery rates depends on whether or not referral restrictions are present.
authors.affiliation: Department of Economics, University of California - San Diego, La Jolla, CA, USA. jshafrin@ucsd.edu
authors.forename: Jason
authors.initials: J
authors.lastname: Shafrin
mesh_terms: D000328:Adult; D002204:Capitation Fee; D003657:Decision Making; D017558:Elective Surgical Procedures / Q000191:economics / Q000706:statistics & numerical data; D018588:Fee-for-Service Plans / Q000191:economics* / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007348:Insurance, Health / Q000145:classification / Q000191:economics; D008297:Male; D018579:Patient Selection; D010816:Physician Incentive Plans / Q000191:economics* / Q000706:statistics & numerical data; D010821:Physicians, Family / Q000191:economics / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000191:economics* / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000191:economics / Q000706:statistics & numerical data; D013043:Specialties, Surgical / Q000191:economics / Q000706:statistics & numerical data; D013514:Surgical Procedures, Operative / Q000191:economics* / Q000706:statistics & numerical data