Burney I L, Schieber G J, Blaxall M O, Gabel J R
JAMA. 1978 Sep 22;240(13):1368-71.
To study geographic differences in physician fees recognized by the Medicare and Medicaid programs, we analyzed physician reimbursement rates at the national, regional, state, and county levels. The results indicate that nationally, Medicaid specialist fees are 77% of Medicare specialist fees. Meidcare specialist fees in metropolitan areas are 23% higher than those in nonmetropolitan areas, but there are no differences under Medicaid. State Medicare specialist fees varied from 73% to 132% of the national Medicare average, while Medicaid specialist fees ranged from 49% to 179% of the national Medicaid average. State Medicaid fees for specialists ranged from 39% to 100% of Medicare specialist fees. These results indicate that under national health insurance, fees set at national or statewide levels could have notable effects on physician remuneration in some localities.
为研究医疗保险和医疗补助计划认可的医生诊疗费用的地区差异，我们分析了国家、区域、州和县级层面的医生报销率。结果表明，在全国范围内，医疗补助计划专科医生的费用是医疗保险计划专科医生费用的77%。医疗保险计划在大都市地区的专科医生费用比非大都市地区高23%，但在医疗补助计划下并无差异。各州医疗保险计划专科医生的费用在全国医疗保险平均水平的73%至132%之间，而医疗补助计划专科医生的费用则在全国医疗补助平均水平的49%至179%之间。各州医疗补助计划专科医生的费用在医疗保险计划专科医生费用的39%至100%之间。这些结果表明，在国家医疗保险制度下，在国家或州层面设定的费用可能会对某些地区的医生薪酬产生显著影响。
