医生支付对患者可及性、使用与健康的影响
The Impacts of Physician Payments on Patient Access, Use, and Health
American Economic Journal: Applied Economics · 2024 · [{"name": "Diane Alexander", "affiliation": ["University of Pennsylvania"]}, {"name": "Molly Schnell", "affiliation": ["Northwestern University"]}]
中文摘要
我们考察供给侧健康保险慷慨程度如何影响患者的可及性、使用与健康。利用 Medicaid 对医生报销费率的大幅外生变化，我们发现，提高新患者门诊就诊的支付会减少关于提供者拒收受益人的报告：缩小 Medicaid 与私人保险公司之间的支付差距，将减少成年人就医可及性差异的一半以上，并消除儿童中的此类差异。我们进一步发现，更高的医生报销导致更多门诊就诊、更好的自评健康，以及该计划受益人中缺课率的降低。（JEL G22, H51, I11, I13, I18, I38, J44）
Abstract
We examine how supply-side health insurance generosity affects patient access, use, and health. Exploiting large, exogenous changes in Medicaid reimbursement rates for physicians, we find that increasing payments for new patient office visits reduces reports of providers turning away beneficiaries: closing the gap in payments between Medicaid and private insurers would reduce more than half of disparities in access among adults and would eliminate such disparities among children. We further find that higher physician reimbursement leads to more office visits, better self-reported health, and reduced school absenteeism among the program’s beneficiaries. (JEL G22, H51, I11, I13, I18, I38, J44)