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The impact of changes in a physician fee schedule on medical expenditures, fees, and volume of services. Evidence from a national fee schedule reform in Australia

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  • Jun, Dajung
  • Scott, Anthony

Abstract

We examine the impact of changes to a national physician fee schedule on total medical expenditures, the volume of services, and fees charged. In our context, changes to the fee schedule were designed to promote value-based health care, and so included different types of changes to subsidised medical services, including changes to fees. Using claims data from a sample of doctors linked to a physician survey, we use difference-in-difference methods with a staggered adoption design to compare medical services which were affected with those which were not. We show that medical expenditures and the volume of affected services fell, though there is uncertainty about the magnitude of the fall. For GPs, we find evidence of increases in expenditures and fees and an increase in fees for some services provided by specialists.

Suggested Citation

  • Jun, Dajung & Scott, Anthony, 2023. "The impact of changes in a physician fee schedule on medical expenditures, fees, and volume of services. Evidence from a national fee schedule reform in Australia," Social Science & Medicine, Elsevier, vol. 337(C).
    • Handle: RePEc:eee:socmed:v:337:y:2023:i:c:s0277953623006263
    DOI: 10.1016/j.socscimed.2023.116269
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    References listed on IDEAS

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    1. Jeffrey Clemens & Joshua D. Gottlieb, 2014. "Do Physicians' Financial Incentives Affect Medical Treatment and Patient Health?," American Economic Review, American Economic Association, vol. 104(4), pages 1320-1349, April.
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    4. E. Glen Weyl & Michal Fabinger, 2013. "Pass-Through as an Economic Tool: Principles of Incidence under Imperfect Competition," Journal of Political Economy, University of Chicago Press, vol. 121(3), pages 528-583.
    5. Gravelle, Hugh & Hole, Arne Risa & Santos, Rita, 2011. "Measuring and testing for gender discrimination in physician pay: English family doctors," Journal of Health Economics, Elsevier, vol. 30(4), pages 660-674, July.
    6. Stefanie Schurer & Daniel Kuehnle & Anthony Scott & Terence C. Cheng, 2016. "A Man's Blessing or a Woman's Curse? The Family Earnings Gap of Doctors," Industrial Relations: A Journal of Economy and Society, Wiley Blackwell, vol. 55(3), pages 385-414, July.
    7. Callaway, Brantly & Sant’Anna, Pedro H.C., 2021. "Difference-in-Differences with multiple time periods," Journal of Econometrics, Elsevier, vol. 225(2), pages 200-230.
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