Changes in Medicaid physician fees and patterns of ambulatory care.
Controlling for state fixed effects and other factors, this paper estimates the effect of the generosity of Medicaid physician payment levels on the volume and site of ambulatory care received by Medicaid patients compared to privately insured patients. Results indicate that cuts in Medicaid physician fees lead to statistically significant reductions in the number of visits for Medicaid patients compared to privately insured patients. Cuts in fees also lead to a statistically significant shift away from physician offices and toward hospital emergency departments and especially outpatient departments. Primary diagnoses for which site of care shifts are most pronounced include hypertension, asthma, urinary tract infections, and diabetes.
Decker
Sandra L
SL
National Center for Health Statistics, 3311 Toledo Road, Room 3316, Hyattsville, MD 20782, USA. SDecker@cdc.gov
D000367:Age Factors; D000553:Ambulatory Care / Q000191:economics / Q000706:statistics & numerical data*; D005251:Fees, Medical / Q000706:statistics & numerical data*; D006296:Health Services / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data; D006302:Health Services Research; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000191:economics / Q000706:statistics & numerical data*; D008484:Medicaid / Q000458:organization & administration* / Q000706:statistics & numerical data*; D044469:Racial Groups; D012111:Residence Characteristics; D012737:Sex Factors; D014481:United States