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Physicians' fees and public medical care programs

R H Lee, J Hadley

Health Services Research

|January 1, 1981

Summary

Medicare and Medicaid subsidies influence physician pricing. Increased physician supply lowers prices, and price controls limit cost increases, affecting healthcare access.

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Area of Science:

Health Economics
Medical Economics
Healthcare Policy

Background:

Physician pricing models often overlook the impact of public insurance programs.
Understanding factors influencing physician fees is crucial for healthcare cost management.
Previous research has not fully integrated demand subsidies from Medicare and Medicaid into physician pricing models.

Purpose of the Study:

To develop and estimate an economic model of physician pricing that incorporates Medicare and Medicaid demand subsidies.
To analyze how these subsidies affect physicians' pricing strategies and market behavior.
To investigate the relationship between physician supply, pricing, and the effectiveness of price controls.

Main Methods:

Developed a multiperiod model of monopolistic competition for physician services.
Estimated the model using claims data from 1,200 California physicians (1972-1975).
Analyzed the elasticity of demand for physician services and the impact of local physician supply.

Main Results:

The demand for physician services was found to be relatively elastic.
Increases in the local supply of physicians led to a moderate reduction in prices.
Physicians demonstrated strategic responses to customary-prevailing-reasonable pricing systems.
Price controls were effective in limiting the rate of increase in physicians' prices.

Conclusions:

Public programs' monopsony power can be leveraged to influence healthcare costs.
Policy interventions can alter the trade-off between healthcare costs and access.
The study provides insights into developing effective healthcare pricing and reimbursement policies.

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