Howard David H, Horný Michal, Dillender Marcus
Department of Health Policy and Management, Emory University, 1518 Clifton Road NE, Atlanta, GA, 30322, USA.
School of Public Health & Health Sciences, University of Massachusetts, Amhert, MA, USA.
Int J Health Econ Manag. 2025 Jul 23. doi: 10.1007/s10754-025-09398-3.
Based on the belief that fee-for-service reimbursement contributes to the overuse of costly medical procedures, policymakers have sought to cut payments for low-value services. Using a difference-in-differences model and Medicare claims linked with cancer registry records, we evaluate the impact of a large payment reduction for an imaging procedure commonly used in prostate cancer patients. We find that the payment cut did not affect imaging use, even in low-risk patients for whom imaging is not recommended. Our results suggest that supply may be relatively insensitive to fee levels when decisions about the use of a service are made exclusively by referring physicians, not the physicians who deliver and receive payment for it.
基于按服务收费报销会导致昂贵医疗程序过度使用的信念，政策制定者试图削减低价值服务的支付费用。我们使用差异-in-差异模型以及与癌症登记记录相关联的医疗保险索赔数据，评估大幅降低一种常用于前列腺癌患者的成像程序支付费用的影响。我们发现，即使在不建议进行成像检查的低风险患者中，支付费用的削减也未影响成像检查的使用。我们的结果表明，当关于服务使用的决策完全由转诊医生而非提供服务并收取费用的医生做出时，供给可能对费用水平相对不敏感。
