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医疗服务提供者何时(以及为何)不对支付标准的变化作出反应

When (and why) providers do not respond to changes in reimbursement rates
Journal of Public Economics · 2022 · Marcus Dillender、Lu Jinks、Anthony T. Lo Sasso

中文摘要

如果医疗服务提供者因支付标准下调而减少供给,旨在削减医疗服务支付额的政策就可能造成医疗服务可及性问题。我们考察了一项将工伤保险体系中的医疗服务支付标准下调30%的政策的影响;即使在下调后,该体系的支付标准相对于其他支付方仍较为优厚。结果提示,在我们所研究的医疗服务支付标准分布区间内,医疗服务提供者的供给缺乏弹性。我们的估计表明,该政策使每年的工伤保险医疗费用减少了超过4亿美元,且未影响受伤工人的医疗服务利用或健康状况。

Abstract

Policies to reduce health care payments can lead to health care access issues if providers reduce their supply in response to reimbursement rate reductions. We examine the impact of a policy that reduced reimbursement rates by 30% in a workers’ compensation insurance system that provided generous reimbursement rates relative to other payers even after the rate reduction. The results suggest that providers’ supply is inelastic at the part of the reimbursement distribution that we study. Our estimates indicate that the policy reduced annual workers’ compensation medical costs by over $400 million without affecting injured workers’ health care utilization or health.
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