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The Impacts of Physician Payments on Patient Access, Use, and Health (WP-19-23)

Diane Alexander and Molly Schnell

The researchers examine how supply-side health insurance generosity affects patient
access, use, and health. Exploiting large, exogenous changes in Medicaid reimbursement
rates for physicians, they find that increasing payments for new patient office visits reduces
reports of providers turning away beneficiaries: Closing the gap in payments between
Medicaid and private insurers would reduce more than two-thirds of disparities in access
among adults and would eliminate such disparities entirely among children. These
improvements in access lead to more office visits, better self-reported health, and reduced
school absenteeism. While attention is often focused on the role of demand-side insurance
generosity, such as program eligibility and patient cost-sharing, the authors’ results
demonstrate that financial incentives for physicians drive access to care and have
important implications for patient health.

Diane Alexander, Assistant Professor of Health Care Management, Wharton School, University of Pennsylvania

Molly Schnell, Assistant Professor of Economics and IPR Fellow, Northwestern University

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