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Journal Article

Measuring Medicaid Physician Participation Rates and Implications for Policy

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Benjamin D. Sommers, Richard Kronick
J Health Polit Policy Law (2016) 41 (2): 211–224.
DOI: https://doi.org/10.1215/03616878-3476117
Published: 01 April 2016
...Benjamin D. Sommers; Richard Kronick Abstract Policy makers continue to debate Medicaid expansion under the Affordable Care Act, and concerns remain about low provider participation in the program. However, there has been little research on how various measures of physician participation may...
FIGURES
View articletitled, Measuring Medicaid <span class="search-highlight">Physician</span> <span class="search-highlight">Participation</span> Rates and Implications for Policy View PDF for article titled, Measuring Medicaid <span class="search-highlight">Physician</span> <span class="search-highlight">Participation</span> Rates and Implications for Policy
Journal Article

Physician Participation in Medicaid: Background and Issues

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Stephen M. Davidson
J Health Polit Policy Law (1982) 6 (4): 703–717.
DOI: https://doi.org/10.1215/03616878-6-4-703
Published: 01 August 1982
... of Medicaid participation by office-based primary care physicians is described, and a number of obstacles to their participation are identified. The obstacles include state policies regarding eligibility, coverage, and provider compensation. The article recommends actions pertaining to these policies...
View articletitled, <span class="search-highlight">Physician</span> <span class="search-highlight">Participation</span> in Medicaid: Background and Issues View PDF for article titled, <span class="search-highlight">Physician</span> <span class="search-highlight">Participation</span> in Medicaid: Background and Issues
Journal Article

Balance Billing Under Medicare: Protecting Beneficiaries and Preserving Physician Participation

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David C. Colby, Thomas Rice, Jill Bernstein, Lyle Nelson
J Health Polit Policy Law (1995) 20 (1): 49–74.
DOI: https://doi.org/10.1215/03616878-20-1-49
Published: 01 February 1995
...David C. Colby; Thomas Rice; Jill Bernstein; Lyle Nelson Medicare's experience with balance billing provides valuable lessons for policy making for national or state health care reform. Medicare developed several policies to encourage physicians to become participating providers who accept Medicare...
View articletitled, Balance Billing Under Medicare: Protecting Beneficiaries and Preserving <span class="search-highlight">Physician</span> <span class="search-highlight">Participation</span> View PDF for article titled, Balance Billing Under Medicare: Protecting Beneficiaries and Preserving <span class="search-highlight">Physician</span> <span class="search-highlight">Participation</span>
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Figure 2a. ACO Participation in Physician Performance Management/Accountability, Percentage within Cluster That Participate

ACO Participation in Physician Performance Management/Accountability, Perce...

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in Accountable Care Organizations: The National Landscape > Journal of Health Politics, Policy and Law
Published: 01 August 2015
Figure 2a ACO Participation in Physician Performance Management/Accountability, Percentage within Cluster That Participate More
Journal Article

Physicians' Decisions to Limit Medicaid Participation: Determinants and Policy Implications

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Janet D. Perloff, Phillip R. Kletke, Kathryn M. Neckerman
J Health Polit Policy Law (1987) 12 (2): 221–236.
DOI: https://doi.org/10.1215/03616878-12-2-221
Published: 01 April 1987
...Janet D. Perloff; Phillip R. Kletke; Kathryn M. Neckerman Although most primary care physicians participate in state Medicaid programs, they may accept all Medicaid patients, or they may choose to limit their participation. This decision allows physicians to adjust their Medicaid caseloads...
View articletitled, <span class="search-highlight">Physicians</span>&#x27; Decisions to Limit Medicaid <span class="search-highlight">Participation</span>: Determinants and Policy Implications View PDF for article titled, <span class="search-highlight">Physicians</span>&#x27; Decisions to Limit Medicaid <span class="search-highlight">Participation</span>: Determinants and Policy Implications
Journal Article

The Limits of Marginal Economic Incentives in the Medicaid Program: Concerns and Cautions

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Thomas Fanning, Martin de Alteriis
J Health Polit Policy Law (1993) 18 (1): 27–42.
DOI: https://doi.org/10.1215/03616878-18-1-27
Published: 01 February 1993
...Thomas Fanning; Martin de Alteriis In January 1985, New York State implemented legislation that allowed for a 30 percent increase in Medicaid fees for physicians providing primary care services. This was intended to increase their levels of participation. Yet the outcome was not as expected...
View articletitled, The Limits of Marginal Economic Incentives in the Medicaid Program: Concerns and Cautions View PDF for article titled, The Limits of Marginal Economic Incentives in the Medicaid Program: Concerns and Cautions
Journal Article

Antitrust Law and Collective Physician Negotiations with Third Parties: The Relative Value Guide Object Lesson

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Rickard F. Pfizenmayer
J Health Polit Policy Law (1982) 7 (1): 128–162.
DOI: https://doi.org/10.1215/03616878-7-1-128
Published: 01 February 1982
...Rickard F. Pfizenmayer This article examines the role of collective physician participation in the third-party reimbursement system. It critiques the Havighurst-Kissam analysis of the antitrust implications of professionally-developed relative value guides and using lessons derived from the only...
View articletitled, Antitrust Law and Collective <span class="search-highlight">Physician</span> Negotiations with Third Parties: The Relative Value Guide Object Lesson View PDF for article titled, Antitrust Law and Collective <span class="search-highlight">Physician</span> Negotiations with Third Parties: The Relative Value Guide Object Lesson
Journal Article

Physicians' Perceptions of Commercial and Medicaid Managed Care Plans: A Comparison

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Gail Silverstein
J Health Polit Policy Law (1997) 22 (1): 5–21.
DOI: https://doi.org/10.1215/03616878-22-1-5
Published: 01 February 1997
...Gail Silverstein Physician participation in fee-for-service Medicaid programs has been declining nationally since the mid-1970s. Numerous studies have documented the reasons for this decline, including poor reimbursement, payment delays, and administrative burdens. Most are now incorporating...
View articletitled, <span class="search-highlight">Physicians</span>&#x27; Perceptions of Commercial and Medicaid Managed Care Plans: A Comparison View PDF for article titled, <span class="search-highlight">Physicians</span>&#x27; Perceptions of Commercial and Medicaid Managed Care Plans: A Comparison
Journal Article

Interest-Based Mediation of Medical Malpractice Lawsuits: A Route to Improved Patient Safety?

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Chris Stern Hyman, Carol B. Liebman, Clyde B. Schechter, William M. Sage
J Health Polit Policy Law (2010) 35 (5): 797–828.
DOI: https://doi.org/10.1215/03616878-2010-028
Published: 01 October 2010
... demonstrates that major challenges stand in the way of achieving mediation's full benefits. Absence of physician participation minimizes the chances that mediated discussion of adverse events and medical errors can lead to improved quality of care. Change will require medical leaders, hospital administrators...
View articletitled, Interest-Based Mediation of Medical Malpractice Lawsuits: A Route to Improved Patient Safety? View PDF for article titled, Interest-Based Mediation of Medical Malpractice Lawsuits: A Route to Improved Patient Safety?
Journal Article

Hmos for Medicaid: The Road to Financial Independence Is Often Poorly Paved

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Joan L. Buchanan, Phoebe A. Lindsey, Arleen Leibowitz, Allyson Ross Davies
J Health Polit Policy Law (1992) 17 (1): 71–96.
DOI: https://doi.org/10.1215/03616878-17-1-71
Published: 01 February 1992
... often lose their Medicaid eligibility. Traditional HMOs control the amount of services provided through physician selec- tion, financial incentives on physicians, and monitoring and utilization review. Lack of information and the difficulty inherent in attracting sufficient provider participation...
View articletitled, Hmos for Medicaid: The Road to Financial Independence Is Often Poorly Paved View PDF for article titled, Hmos for Medicaid: The Road to Financial Independence Is Often Poorly Paved
Journal Article

Public Sector Primary Care and Medicaid: Trading Accessibility for Mainstreaming

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James W. Fossett, John A. Peterson, Mary C. Ring
J Health Polit Policy Law (1989) 14 (2): 309–325.
DOI: https://doi.org/10.1215/03616878-14-2-309
Published: 01 April 1989
.... 1989 . Physician Supply and Medicaid Participation: The Causes of Market Failure. Medical Care 27 . Freeman , H. , R. Blendon, and L. Aiken, et al. 1987 . Americans Report on Their Access to Care. Health Affairs 6 : 6 -19. Garner , D. , W. Liao, and T. Sharpe. 1979 . Factors...
View articletitled, Public Sector Primary Care and Medicaid: Trading Accessibility for Mainstreaming View PDF for article titled, Public Sector Primary Care and Medicaid: Trading Accessibility for Mainstreaming
Journal Article

Medicaid: Taking Stock

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Stephen M. Davidson
J Health Polit Policy Law (1993) 18 (1): 43–66.
DOI: https://doi.org/10.1215/03616878-18-1-43
Published: 01 February 1993
... Research. Davidson , S. 1982 . Physician Participation in Medicaid: Background and Issues. Journal of Health Politics, Policy and Law 6 : 703 -17. Davidson , S. 1985 . Regional Differences in Medicaid: Their Origins and Effects. Unpublished manuscript. Davidson , S. 1992...
View articletitled, Medicaid: Taking Stock View PDF for article titled, Medicaid: Taking Stock
Journal Article

Physician Payment and Cost-Containment Strategies in West Germany: Suggestions for Medicare Reform

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Bradford L. Kirkman-Liff
J Health Polit Policy Law (1990) 15 (1): 69–99.
DOI: https://doi.org/10.1215/03616878-15-1-69
Published: 01 February 1990
...-governmental advisory body. Aspects of this structure could be adopted by Medicare in order to determine conversion factors for resource-based relative value scales or to create expenditure control and incentive structures for Medicare-participating physicians. Copyright © 1990 by Duke University Press 1990...
View articletitled, <span class="search-highlight">Physician</span> Payment and Cost-Containment Strategies in West Germany: Suggestions for Medicare Reform View PDF for article titled, <span class="search-highlight">Physician</span> Payment and Cost-Containment Strategies in West Germany: Suggestions for Medicare Reform
Journal Article

To Extend or Not to Extend the Primary Care “Fee Bump” In Medicaid?

Open Access
Adam S. Wilk, David K. Jones
J Health Polit Policy Law (2014) 39 (6): 1263–1275.
DOI: https://doi.org/10.1215/03616878-2829495
Published: 01 December 2014
... ; Zuckerman et al. 2004 , though effects will be more significant for some physicians than for others (Wilk 2013 ). Thus, quite substantial fee increases may be required to achieve meaningful improvements in PCP participation. Yet the magnitude of the ACA's fee increases is quite large in some states...
FIGURES
View articletitled, To Extend or Not to Extend the Primary Care “Fee Bump” In Medicaid? View PDF for article titled, To Extend or Not to Extend the Primary Care “Fee Bump” In Medicaid?
Journal Article

Health Policy Research and Secondary Data Sets

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Thomas Fanning, Martin de Alteriis
J Health Polit Policy Law (1993) 18 (1): 71–74.
DOI: https://doi.org/10.1215/03616878-18-1-71
Published: 01 February 1993
... the reader should concentrate on one point. While we don’t know if substantially higher fees would be sufficient to raise physician participation in the program, we do know that substantially higher fees should be a necessary part of any policy directed toward that goal. We have no doubt...
View articletitled, Health Policy Research and Secondary Data Sets View PDF for article titled, Health Policy Research and Secondary Data Sets
Journal Article

A Tale of Two Bounties: The Impact of Competing Fees on Physician Behavior

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Thomas Rice, Sally C. Stearns, Donald E. Pathman, Susan DesHarnais, Michelle Brasure ...
J Health Polit Policy Law (1999) 24 (6): 1307–1330.
DOI: https://doi.org/10.1215/03616878-24-6-1307
Published: 01 December 1999
... Adams , E. K. 1995 . Effect of Increased Medicaid Fees on Physician Participation and Enrollee Service Utilization in Tennessee, 1985–1988. Inquiry 31 ( 2 ): 173 -187. Christensen , S. 1992 . Volume Responses to Exogenous Changes in Medicare’s Payment Policies. Health Services Research...
View articletitled, A Tale of Two Bounties: The Impact of Competing Fees on <span class="search-highlight">Physician</span> Behavior View PDF for article titled, A Tale of Two Bounties: The Impact of Competing Fees on <span class="search-highlight">Physician</span> Behavior
Journal Article

Will Medicare Beneficiaries Switch Physicians? A Test of Economic Competition

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Thomas Rice, Lyle Nelson, David C. Colby
J Health Polit Policy Law (1992) 17 (1): 3–24.
DOI: https://doi.org/10.1215/03616878-17-1-3
Published: 01 February 1992
... was not correlated with ability to pay. We conclude that policies aimed at altering consumer demand may not be the most effective way to control Medicare costs. Copyright © 1992 by Duke University Press 1992 References Burney , I. , and J. Paradise. 1987 . Medicare Physician Participation. Health...
View articletitled, Will Medicare Beneficiaries Switch <span class="search-highlight">Physicians</span>? A Test of Economic Competition View PDF for article titled, Will Medicare Beneficiaries Switch <span class="search-highlight">Physicians</span>? A Test of Economic Competition
Journal Article

Factors Associated with Increased Specialty Care Access in an Urban Area: The Roles of Local Workforce Capacity and Practice Location

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Joanna Bisgaier, Karin V. Rhodes, Daniel Polsky
J Health Polit Policy Law (2014) 39 (6): 1173–1183.
DOI: https://doi.org/10.1215/03616878-2829214
Published: 01 December 2014
... Insurance .” Journal of the American Academy of Dermatology 68 , no. 5 : 738 – 48 . Coburn Andrew F. , Long Stephen H. , and Marquis M. Susan . 1999 . “ Effects of Changing Medicaid Fees on Physician Participation and Enrollee Access .” Inquiry 36 , no. 3 : 265 – 79...
View articletitled, Factors Associated with Increased Specialty Care Access in an Urban Area: The Roles of Local Workforce Capacity and Practice Location View PDF for article titled, Factors Associated with Increased Specialty Care Access in an Urban Area: The Roles of Local Workforce Capacity and Practice Location
Journal Article

Medicaid and Pediatric Primary Care

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Deborah A. Freund
J Health Polit Policy Law (1990) 15 (4): 935–937.
DOI: https://doi.org/10.1215/03616878-15-4-935
Published: 01 August 1990
... analyses of what continues to be a critical factor in Medicaid-physician participation, which is a leading indicator of access to medical care for this pop- ulation. The book deals with pediatricians, one of the most important groups of 936 Journal of Health Politics, Policy and Law physicians...
View articletitled, Medicaid and Pediatric Primary Care View PDF for article titled, Medicaid and Pediatric Primary Care
Journal Article

Expanding Medicaid Access without Expanding Medicaid: Why Did Some Nonexpansion States Continue the Primary Care Fee Bump?

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Adam S. Wilk, Leigh C. Evans, David K. Jones
J Health Polit Policy Law (2018) 43 (1): 109–127.
DOI: https://doi.org/10.1215/03616878-4249861
Published: 01 February 2018
.... Consequently, most states were playing catch-up and did not fully implement the fee bump until late 2013. This meant that evidence about its effect on physicians' Medicaid participation levels was severely limited by mid-2014, when states were setting reimbursement levels for 2015, after the fee bump would...
FIGURES
View articletitled, Expanding Medicaid Access without Expanding Medicaid: Why Did Some Nonexpansion States Continue the Primary Care Fee Bump? View PDF for article titled, Expanding Medicaid Access without Expanding Medicaid: Why Did Some Nonexpansion States Continue the Primary Care Fee Bump?