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In the Shadow of a Giant: Medicare’s Influence on Private Physician Payments

机译：在巨人的阴影下：医疗保险对私人医师付款的影响

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We analyze Medicare’s influence on private insurers’ payments for physicians’ services. Using a large administrative change in reimbursements for surgical versus medical care, we find that private prices follow Medicare’s lead. A $1.00 increase in Medicare’s fees increases corresponding private prices by $1.16. A second set of Medicare fee changes, which generates area-specific payment shocks, has a similar effect on private reimbursements. Medicare’s influence is strongest in areas with concentrated insurers and competitive physician markets, consistent with insurer-doctor bargaining. By echoing Medicare’s pricing changes, these payment spillovers amplify Medicare’s impact on specialty choice and other welfare-relevant aspects of physician practices.

机译：我们分析了Medicare对私人保险公司向医生提供服务的付款的影响。通过对手术和医疗报销进行重大的行政变更，我们发现私人价格遵循了Medicare的领导。 Medicare的费用每增加$ 1.00，相应的私人价格就会上涨$ 1.16。第二套Medicare费用变更会产生针对特定地区的付款冲击，对私人报销也有类似的影响。在保险公司集中且竞争激烈的医师市场领域，医疗保险的影响力最大，这与保险公司与医生的讨价还价一致。通过顺应Medicare的价格变化，这些付款溢出效应扩大了Medicare对专业选择和其他与医生实践有关的福利方面的影响。

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期刊名称 other
作者
Jeffrey Clemens; Joshua D. Gottlieb;
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年(卷),期 -1(125),1
年度 -1
页码 1–39
总页数 38
原文格式 PDF
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专利

1. Value-based payment for physicians in medicare: Small step or giant leap [J] . RyanA.M., PressM.J. Annals of Internal Medicine . 2014,第8期

机译：医疗保险中医师的基于价值的支付：小步或大跃进
2. Contrary to cost-shift theory, lower medicare hospital payment rates for inpatient care lead to lower private payment rates [J] . WhiteC. Health affairs . 2013,第5期

机译：与成本转移理论相反，较低的医疗保险住院支付费用率导致较低的私人支付率
3. Fee-for-service will remain a feature of major payment reforms, requiring more changes in medicare physician payment. [J] . Paul B Ginsburg Health affairs . 2012,第9期

机译：按服务付费将仍然是主要支付改革的一个特征，需要对医疗保险医生支付进行更多的更改。
4. A Novel Method for Fraudulent Medicare Claims Detection from Expected Payment Deviations (Application Paper) [C] . Richard A. Bauder, Taghi M. Khoshgoftaar IEEE International Conference on Information Reuse and Integration . 2016

机译：从预期付款偏差中发现欺诈性医疗保险索赔的新方法（应用论文）
5. The therapy threshold within the Medicare prospective payment system: Associated ethical dilemmas and influence to therapy practice patterns and quality of patient care. [D] . Collins, Tracey L. 2006

机译：Medicare预期付款系统中的治疗阈值：相关的道德困境以及对治疗实践模式和患者护理质量的影响。
6. Building a consensus for physician payment reform in Medicare. The Physician Payment Review Commission. [O] . P R Lee, P B Ginsburg 1988

机译：在Medicare中建立医师支付改革共识。医师付款审查委员会。
7. In the Shadow of a Giant: Medicare’s Influence on Private Physician Payments [O] . Jeffrey Clemens, Joshua D. Gottlieb 2017

机译：在巨人的阴影下：Medicare对私人医师的影响

In the Shadow of a Giant: Medicare’s Influence on Private Physician Payments

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