Abstract
One question which has been the subject of debate, without resolution, in the health economics literature is whether physicians face distorted incentives. This paper examines the possible effects of an attempt to “correct” the incentives facing physician firms: namely the use of a relative valued fee schedule. Though a type of relative value scale is currently under implementation for the Medicare system, little is known about the effects of such mechanisms. This paper attempts to glean information from natural experiments by several state Medicaid programs that have used relative value scales in the past.
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References
Aigner, D., C.A.K. Lovell, and P. Schmidt (1977) ‘Formulation and Estimation of Stochastic Frontier Production Function Models’,Journal of Econometrics,6, 21–37.
Bauer, P.W. (1990) ‘Recent Developments in the Econometric Estimation of Frontiers’,Journal of Econometrics,46, 39–56.
Bradford, W.D. and R.E. Martin (1992) ‘Medicaid and Two-Tiered Health Care Physician Firms and Quality Choice’, Whittemore School of Business and Economics Working Paper, 001.
Braun, P.et al. (1988) ‘Cross Specialty Linkage of Resource-Based Relative Value Scales’,Journal of the American Medical Association,260(16), 2390–2396.
Brown, D.M., and H.E. Lapan (1979) ‘The Supply of Physicians' Services’,Economic Inquiry,17(2, 269–279.
Burstein, Philip L., and Jerry Cromwell (1985) ‘Relative Incomes and Rates of Return for U.S. Physicians’,Journal of Health Economics,4(1), 63–78.
Douglas, S.M., Conway, K.S., and G.D. Ferrier (1994) ‘A Switching Regression Frontier Model with Imperfect Sample Separation Information: With an Application to Constrained Labor Supply’,International Economic Review,36(2), forthcoming.
Department of Health Services, Health and Welfare Agency of the State of California (1991) ‘Report to the Legislature: Review of Physician and Dental Reimbursement Levels in the Medi-Cal Program’, January.
Eakin, B.K, ‘Do Physicians Minimize Cost? A Comparison of Group and Solo Practices’, mimeo, Department of Economics, University of Oregon.
Eisenberg, J.M. and A. Kabcenell (1988) ‘Organized Practice and the Quality of Medical Care’,Inquiry,25(1), 78–89.
Escarce, J.J. (1991) ‘Geographic Variation in Relative Fees under Medicare’,American Journal of Public Health,81(11), 1491–1493.
Ferguson, B.S. (1985) ‘Physician Objectives and Resource Allocation’,Journal of Health Economics,4, 35–42.
Gaynor, M. and M.V. Pauly (1990) ‘Compensation and Productive Efficiency in Partnerships: Evidence from Medical Group Practice’,Journal of Political Economy,98(3), 544–573.
Goodman, Louis J., and Fredric D. Wolinsky (1982) ‘Conditional Logit Analysis of Physicians' Practice Mode Choices’,Inquiry,19(3), 267–270.
Hsiao, William C.,et al. (1988a) ‘Estimating Physicians' Work for a Resource-Based Relative-Value Scale’,New England Journal of Medicine,31(13), 835–841.
Hsiao, William C.,et al. (1988b) ‘Resource-Based Relative Values’,Journal of the American Medical Association,260(16), 2347–2353.
Hsiao, William C.,et al. (1988c) ‘Results, Potential Effects, and Implementation Issues of the Resource-Based Relative Value Scale’,Journal of the American Medical Association,260(16), 2429–2445.
Kelly, N.L.,et al. (1988) ‘Extrapolation of Measures of Work for Surveyed Services to Other Services’,Journal of the American Medical Association,260(16), 2379–2384.
Kumbhakar, S.C. (1987) ‘The Specification of Technical and Allocative Inefficiency in Stochastic Production and Profit Frontiers’,Journal of Econometrics,34, 335–348.
McCombs, J.S. (1984) ‘Physician Treatment Decisions in a Multiple Treatment Model’,Journal of Health Economics,3, 155–171.
Newhouse, Joseph P. (1973) ‘The Economics of Group Practice’,The Journal of Human Resources,8(1), 37–56.
Noether, Monica (1986) ‘The Growing Supply of Physicians: Has the Market Become More Competitive?’Journal of Labor Economics,4(4), 503–537.
Pope, G.C. and K. Merrell (1992) ‘Payment Areas for Physician Services’,Inquiry,29 (Spring): 9–20.
Reinhardt, U. (1972) ‘A Production Function for Physician Services’,Review of Economics and Statistics,54 (February), 55–66.
Rizzo, John A. and Richard J. Zeckhauser (1990) ‘Advertising and the Price, Quantity and Quality of Primary Care Physician Services’,Journal of Human Resources,27(3), 381–421.
Schmidt, P. and C.A.K. Lovell (1979) ‘Estimating Technical and Allocative Inefficiency Relative to Stochastic Production and Cost Frontiers’,Journal of Econometrics,9, 343–366.
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The author would like to express his appreciation to Karen Smith Conway, Thomas Hoerger, and Torsten Schmidt for their helpful comments and suggestions. Valuable research assistance was provided by Sharon Kunz. All remaining errors are, of course, the sole responsibility of the author.
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Bradford, W.D. The effects of a relative value reimbursement scheme on the medical market: Lessons from medicaid. Rev Ind Organ 10, 511–532 (1995). https://doi.org/10.1007/BF01024233
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DOI: https://doi.org/10.1007/BF01024233