Hadley Jack, Reschovsky James, Corey Catherine, Zuckerman Stephen
Department of Health Administration and Policy, George Mason University, Fairfax, VA 22030, USA.
Inquiry. 2009;46(4):372-90. doi: 10.5034/inquiryjrnl_46.4.372.
This paper estimates the relationship between Medicare fees and quantities provided by physicians for eight specific services. It uses data for 13,707 physicians who responded to surveys in 2000/2001 and/or 2004/2005 and were linked to all Medicare claims for their Medicare patients. Results show that Medicare fees are positively related to quantity provided for all eight services, and are significantly different from zero and elastic for five of them. The findings are consistent with the general economic proposition that supply curves for medical services are positively sloped, and provide no evidence of volume-offset behavior for the services examined. These results also imply that Medicare could influence volume growth for specific services by varying their fee changes, and that uniform fee changes will have differential effects on service volume because of variation in underlying supply elasticities.
本文估计了医疗保险费用与医生提供的八项特定服务数量之间的关系。它使用了2000/2001年和/或2004/2005年回复调查的13707名医生的数据,这些医生与他们医疗保险患者的所有医疗保险索赔相关联。结果表明,医疗保险费用与所有八项服务的提供数量呈正相关,其中五项服务的费用与数量显著不同且具有弹性。这些发现与医疗服务供给曲线斜率为正的一般经济命题一致,并且没有为所研究的服务提供数量抵消行为的证据。这些结果还意味着医疗保险可以通过改变特定服务的费用变化来影响其数量增长,并且由于潜在供给弹性的差异,统一的费用变化将对服务数量产生不同的影响。