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Access to care under physician payment reform: a physician-based analysis
1Office of Research and Demonstrations, Health Care Financing Administration, Baltimore, MD 21244, USA.
Health Care Financing Review
|December 4, 1995
Summary
Physician payment reforms in 1989 did not negatively impact patient access to care. Analysis of Medicare claims showed stable physician caseloads and assignment rates, indicating consistent access to healthcare services.
Area of Science:
- Health Services Research
- Medical Economics
- Public Health Policy
Background:
- The 1989 physician payment reforms aimed to alter physician reimbursement structures.
- Understanding the impact of these reforms on healthcare access is crucial for policy evaluation.
Purpose of the Study:
- To assess physician-based measures of access to care in the years surrounding the 1989 reforms.
- To determine if the reforms adversely affected patient access to physicians and procedures.
Main Methods:
- Utilized a novel system of physician identifiers within Medicare claims data for analysis.
- Examined access metrics including physician caseload, client demographics, procedure performance rates, and assignment rates.
Main Results:
- Physician caseload and assignment rates remained stable or improved post-reform.
- Procedure performance rates showed a slight decline in 1992-1993, inversely correlated with fee changes and potentially influenced by other factors.
Conclusions:
- The 1989 physician payment reforms did not appear to negatively impact overall access to care.
- Findings suggest that Medicare claims data, with new identifiers, can effectively track access measures over time.