Access to care under physician payment reform: a physician-based analysis.
Date of Pub
This article reports physician-based measures of access to care during the 3 years surrounding the 1989 physician payment
reforms. Analysis was facilitated by a new system of physician identifiers in Medicare claims. Access measures include caseload
per physician and related measures of the demographic composition of physicians' clientele, the proportion of physicians performing
surgical and other procedures, and the assignment rate. The caseload and assignment measures were stable or improving over
time, suggesting that reforms did not harm access. Procedure performance rates tended to decline between 1992 and 1993, but
reductions were inversely related to the estimated fee changes, and several may be explainable by other factors.
Reimbursement Mechanisms : Aged : Blacks/statistics & numerical data : Fee Schedules : Health Services Accessibility/economics/trends
: Human : Medicare Assignment/statistics & numerical data : Medicare Part B/legislation & jurisprudence/utilization : Physicians/classification/utilization
: Specialties, Medical/economics/statistics & numerical data : Surgical Procedures, Operative/classification/economics : United
States : United States Health Care Financing Administration : Whites/statistics & numerical data : Workload/statistics & numerical