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Physician behavior under the Medicare assignment option.

J B Mitchell, J Cromwell

Journal of Health Economics

|November 7, 1982

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Physician Medicare assignment rates are highly sensitive to reimbursement and administrative policies. Higher prevailing charges increase assignment, while stronger demand for non-assigned services decreases it.

Area of Science:

Health Policy
Medical Economics
Physician Behavior

Background:

Medicare's physician payment system significantly impacts healthcare access.
Understanding physician participation in Medicare assignment is crucial for program effectiveness.

Purpose of the Study:

To analyze factors influencing physicians' willingness to accept Medicare patients on assignment.
To identify physician characteristics associated with higher assignment rates.

Main Methods:

Analysis of a national physician sample (general practitioners, internists, general surgeons).
Statistical examination of the relationship between Medicare reimbursement rates, administrative practices, and assignment acceptance.

Main Results:

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Assignment rates demonstrated high sensitivity to Medicare's reimbursement and administrative practices.
A 10% increase in prevailing charge correlated with a 14.7% rise in assignment acceptance.
Assignment rates were inversely related to the demand for non-assigned Medicare services.
General surgeons and foreign medical graduates were disproportionately represented among physicians accepting assignment.

Conclusions:

Medicare reimbursement levels and administrative burdens are key determinants of physician assignment acceptance.
The Medicare program's assigned and non-assigned services compete, affecting overall physician participation.
Targeted strategies may be needed to encourage broader physician acceptance of Medicare assignment, particularly among certain specialties.