Trading spaces: Medicare's regulatory spillovers on treatment setting for non-Medicare patients.

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Date: July 2022
Publisher: Elsevier B.V.
Document Type: Report; Brief article
Length: 363 words

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Abstract :

Keywords Physician; Medicare; Healthcare regulation; Ambulatory surgery center Abstract Medicare pricing is known to indirectly influence provider prices and care provision for non-Medicare patients; however, Medicare's regulatory externalities beyond fee-setting are less well understood. We study how physicians' outpatient surgery choices for non-Medicare patients responded to Medicare removing a ban on ambulatory surgery center (ASC) use for a specific procedure. Following the rule change, surgeons began reallocating both Medicare and commercially insured patients to ASCs. Specifically, physicians became 70% more likely to use ASCs for the policy-targeted procedure among their non-Medicare patients. These novel findings demonstrate that Medicare rulemaking affects physician behavior beyond the program's statutory scope. Author Affiliation: (a) Department of Economics, University of Texas-Austin, BRB 1.116, Stop C3100, Austin TX 78712, USA (b) Department of Economics, Baylor University, One Bear Place Waco TX 76798, USA * Corresponding author. Article History: Received 20 August 2021; Revised 17 February 2022; Accepted 21 April 2022 (footnote) Conflict of interest: We have not conflicts. (footnote) We are grateful to Leila Agha, Lindsey Bullinger, Marika Cabral, Colleen Carey, Alice Chen, Paul Ginsburg, Atul Gupta, Bart Hamilton, Matt Harris, Darius Lakdawalla, Neale Mahoney, Beth Munnich, Maria Polyakova, Rosalie Pacula, David Powell, Seth Richards-Shubik, John Romley, Steve Ryan, Adam Sacarny, Neeraj Sood, and seminar participants at the University of Houston, University of Southern California, and Washington University in St. Louis for many helpful comments on earlier versions of this work. We are also grateful to the participants and organizers of the 2019 ASHEcon meeting, the 2019 Southeastern Health Economics Study Group, and the 2020 Junior Health Economics Summit for opportunities to present this research. We also especially thank Beth Munnich for generous data sharing related to physician ASC investments. We thank the Florida Agency for Health Care Administration (AHCA) for providing the data for this project and note that AHCA was not responsible for any data analyses or interpretations belonging to this work. We have no conflicts of interest to disclose, and all views and errors are our own. We are especially grateful to the editor, Jeff Clemens, and three annonymous reviewers for excellent suggestions for strengthening this work. Byline: Michael Geruso (a), Michael R. Richards [] (b,*)

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Gale Document Number: GALE|A709525724