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Physician participation in state Medicaid programs
Abstract:
Medicaid requires that physicians who accept Medicaid reimbursement for treating a patient agree to accept its payment as payment in full. Policy instruments under Medicaid's control are both levels of reimbursement and various administrative burdens imposed on physicians by the program. A model depicting the physician's participation decision is developed, and predictions from the comparative statics analysis are discussed. Data came from a 1975--76 survey of fee-for-service physicians. The results indicate that high fee schedules and low administrative burdens are ways to stimulate physician involvement with Medicaid patients. Results on the Medicaid policy instruments and other explanatory variables on the whole lend support to the model of physician behavior proposed earlier in the paper.
Insights
Higher Medicaid reimbursement rates and reduced administrative burdens encourage more physicians to participate in the program, improving access to care for patients. This study models physician participation decisions.
Area of Science:
- Health Economics
- Public Health Policy
- Physician Behavior Analysis
Background:
- Medicaid reimbursement requires physicians to accept payment in full.
- Physician participation in Medicaid is influenced by program policies.
Purpose of the Study:
- To develop and analyze a model of physician participation in Medicaid.
- To identify policy levers that can increase physician involvement with Medicaid patients.
Main Methods:
- Developed a theoretical model of physician participation decisions.
- Conducted comparative statics analysis.
- Utilized data from a 1975-76 survey of fee-for-service physicians.
Main Results:
- Higher fee schedules positively correlate with increased physician participation.
- Lower administrative burdens significantly stimulate physician involvement.
- Model predictions are supported by empirical findings.
Conclusions:
- Medicaid policy can effectively influence physician participation through reimbursement levels and administrative load.
- Optimizing these policy instruments is crucial for enhancing patient access to care.