Medicare inpatient physician charges: an econometric analysis.
Miller, Mark E
Date of Pub
Welch, W Pete
To control Medicare physician payments, Congress in 1989 established volume performance standards (VPS) that tie future physician
fee increases to the growth in expenditures per beneficiary. The VPS risk pool is nationwide, and many observers believe it
is too large to affect behavior. VPS could be modified by defining a separate risk pool for inpatient physician services and
placing each hospital medical staff at risk for those services. Using a national random sample of 500,000 Medicare admissions,
we explore the determinants of medical staff charges and comment on the policy implications. Multivariate analysis shows that
charges increase with case mix and bed size but, surprisingly, decrease with the level of teaching activity. The teaching
result is explained by the substitution of residents for physicians in these hospitals.
Relative Value Scales : Analysis of Variance : Diagnosis-Related Groups/economics : Education, Medical, Graduate/economics
: Fee Schedules/legislation & jurisprudence/statistics & numerical data : Health Services Research : Hospital Bed Capacity/statistics
& numerical data : Hospitals, Teaching/economics : Medical Staff, Hospital/economics : Medicare Part B/economics/statistics
& numerical data : Models, Econometric : Multivariate Analysis : Reimbursement Mechanisms/economics : Support, U.S. Gov't,
Non-P.H.S. : United States