Department of Economics, University of Texas-Austin, BRB 1.116, Stop C3100, Austin TX 78712, USA.
Department of Economics, Baylor University, One Bear Place Waco TX 76798, USA.
J Health Econ. 2022 Jul;84:102624. doi: 10.1016/j.jhealeco.2022.102624. Epub 2022 May 14.
Medicare pricing is known to indirectly influence provider prices and care provision for non-Medicare patients; however, Medicare's regulatory externalities beyond fee-setting are less well understood. We study how physicians' outpatient surgery choices for non-Medicare patients responded to Medicare removing a ban on ambulatory surgery center (ASC) use for a specific procedure. Following the rule change, surgeons began reallocating both Medicare and commercially insured patients to ASCs. Specifically, physicians became 70% more likely to use ASCs for the policy-targeted procedure among their non-Medicare patients. These novel findings demonstrate that Medicare rulemaking affects physician behavior beyond the program's statutory scope.
医疗保险定价被认为会间接影响非医疗保险患者的提供者价格和医疗服务提供；然而，医疗保险在设定费用之外的监管外部性则不太为人所知。我们研究了医疗保险取消对特定手术的门诊手术中心（ASC）使用禁令后，医生对非医疗保险患者门诊手术选择的影响。在规则变更后，外科医生开始将 Medicare 和商业保险患者重新分配到 ASC。具体来说，医生为非 Medicare 患者进行该政策目标手术时，使用 ASC 的可能性增加了 70%。这些新发现表明，医疗保险的规则制定不仅影响了该计划的法定范围，还影响了医生的行为。
