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Beneficiary Liability Under Medicare: Analysis of Physician Participation,Assignment, and Billing Practices

机译：医疗保险下的受益人责任：医师参与，分配和计费实践的分析

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The study is based on the 1988 Physicians' Practice Cost and Income Survey(PPCIS), a national survey of physicians sponsored by the Health Care Financing Administration. A total of 3,505 physicians participated with a response rate of 61 percent. According to the 1988 PPCIS, about half of all physicians (49.4%) signed the Medicare Participating Physician Agreement in April, 1988. This represented a large increase over the number of physicians who signed a Medicare Participating Agreement in 1987 (37%). Participation rates ranged from 30.5 percent for anesthesiologists to 75 percent for cardiovascular/thoracic surgeons. Participation rates rose as Medicare dependence rose. Nonparticipating physicians accepted about one-in-three cases on assignment, on average; while 8 percent of nonparticipants were actually de facto participants in that they accepted 100 percent of their cases on assignment. The study also examined physicians' billing practices for the deductible and coinsurance among assigned patients. Physicians were asked whether they billed patients for the deductible and coinsurance when they were not covered by a supplemental insurance policy or Medicaid. Seventy percent of physicians always billed for the copayments, while 20 percent sometimes billed, and the remaining 10 percent never did so.

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