IDEAS home Printed from https://ideas.repec.org/p/nbr/nberwo/33090.html
   My bibliography  Save this paper

Physician Practice Preferences and Healthcare Expenditures: Evidence from Commercial Payers

Author

Listed:
  • Jeffrey Clemens
  • Pierre-Thomas Léger
  • Yashna Nandan
  • Robert Town

Abstract

We examine the relationship between physician preferences and both the intensity and cost of care delivered to commercially insured heart attack patients. We match survey data on physician preferences, collected by Cutler, Skinner, Stern, and Wennberg (2019) (CSSW), to medical claims data from the Health Care Cost Institute, which spans over 50 million insurance beneficiaries. In contrast to CSSW, who find strong correlations between aggressive practice preferences and both expenditure and utilization for the Medicare population, we find relationships that are both economically and statistically smaller in magnitude within the commercially insured population. Variations in commercial insurers’ prices appear to play an important mediating role.

Suggested Citation

  • Jeffrey Clemens & Pierre-Thomas Léger & Yashna Nandan & Robert Town, 2024. "Physician Practice Preferences and Healthcare Expenditures: Evidence from Commercial Payers," NBER Working Papers 33090, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:33090
    Note: AG EH LS PE
    as

    Download full text from publisher

    File URL: http://www.nber.org/papers/w33090.pdf
    Download Restriction: Access to the full text is generally limited to series subscribers, however if the top level domain of the client browser is in a developing country or transition economy free access is provided. More information about subscriptions and free access is available at http://www.nber.org/wwphelp.html. Free access is also available to older working papers.
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Amitabh Chandra & Douglas O. Staiger, 2007. "Productivity Spillovers in Health Care: Evidence from the Treatment of Heart Attacks," Journal of Political Economy, University of Chicago Press, vol. 115(1), pages 103-140.
    2. Zarek C. Brot-Goldberg & Amitabh Chandra & Benjamin R. Handel & Jonathan T. Kolstad, 2017. "What does a Deductible Do? The Impact of Cost-Sharing on Health Care Prices, Quantities, and Spending Dynamics," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 132(3), pages 1261-1318.
    3. Jonathan I. Dingel & Joshua D. Gottlieb & Maya Lozinski & Pauline Mourot, 2023. "Market Size and Trade in Medical Services," NBER Working Papers 31030, National Bureau of Economic Research, Inc.
    4. 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.
    5. Danil Agafiev Macambira & Michael Geruso & Anthony Lollo & Chima D. Ndumele & Jacob Wallace, 2022. "The Private Provision of Public Services: Evidence from Random Assignment in Medicaid," NBER Working Papers 30390, National Bureau of Economic Research, Inc.
    6. Marika Cabral & Colleen Carey & Sarah Miller, 2021. "The Impact of Provider Payments on Health Care Utilization of Low-Income Individuals: Evidence from Medicare and Medicaid," NBER Working Papers 29471, National Bureau of Economic Research, Inc.
    7. Jeffrey Clemens & Joshua D. Gottlieb & Jeffrey Hicks, 2021. "How Would Medicare for All Affect Health System Capacity? Evidence from Medicare for Some," Tax Policy and the Economy, University of Chicago Press, vol. 35(1), pages 225-262.
    8. Amy Finkelstein & Matthew Gentzkow & Heidi Williams, 2016. "Sources of Geographic Variation in Health Care: Evidence From PatientMigration," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 131(4), pages 1681-1726.
    9. Amanda Starc & Robert J Town, 2020. "Externalities and Benefit Design in Health Insurance," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 87(6), pages 2827-2858.
    10. Jeffrey Clemens & Joshua D. Gottlieb, 2017. "In the Shadow of a Giant: Medicare’s Influence on Private Physician Payments," Journal of Political Economy, University of Chicago Press, vol. 125(1), pages 1-39.
    11. Ivan Badinski & Amy Finkelstein & Matthew Gentzkow & Peter Hull, 2023. "Geographic Variation in Healthcare Utilization: The Role of Physicians," NBER Working Papers 31749, National Bureau of Economic Research, Inc.
    12. David Cutler & Jonathan S. Skinner & Ariel Dora Stern & David Wennberg, 2019. "Physician Beliefs and Patient Preferences: A New Look at Regional Variation in Health Care Spending," American Economic Journal: Economic Policy, American Economic Association, vol. 11(1), pages 192-221, February.
    13. Abe Dunn & Joshua D Gottlieb & Adam Hale Shapiro & Daniel J Sonnenstuhl & Pietro Tebaldi, 2024. "A Denial a Day Keeps the Doctor Away," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 139(1), pages 187-233.
    14. Amitabh Chandra & Evan Flack & Ziad Obermeyer, 2024. "The Health Costs of Cost Sharing," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 139(4), pages 2037-2082.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Calvin Ackley & Abe Dunn & Eli Liebman & Adam Hale Shapiro, 2024. "Are Medicaid and Medicare Patients Treated Equally?," Working Paper Series 2024-14, Federal Reserve Bank of San Francisco.
    2. Attema, Arthur E. & Galizzi, Matteo M. & Groß, Mona & Hennig-Schmidt, Heike & Karay, Yassin & L’Haridon, Olivier & Wiesen, Daniel, 2023. "The formation of physician altruism," Journal of Health Economics, Elsevier, vol. 87(C).
    3. Barili, Emilia & Bertoli, Paola & Grembi, Veronica, 2021. "Neighborhoods, networks, and delivery methods," Journal of Health Economics, Elsevier, vol. 80(C).
    4. Abe Dunn & Joshua D Gottlieb & Adam Hale Shapiro & Daniel J Sonnenstuhl & Pietro Tebaldi, 2024. "A Denial a Day Keeps the Doctor Away," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 139(1), pages 187-233.
    5. Jeffrey P. Clemens & Jonathan M. Leganza & Alex Masucci, 2021. "Plugging Gaps in Payment Systems: Evidence from the Take-Up of New Medicare Billing Codes," CESifo Working Paper Series 9209, CESifo.
    6. Martin Gaynor & Kate Ho & Robert J. Town, 2015. "The Industrial Organization of Health-Care Markets," Journal of Economic Literature, American Economic Association, vol. 53(2), pages 235-284, June.
    7. Yong, Jongsay & Elshaug, Adam G & Mendez, Susan J & Prang, Khic-Houy & Scott, Anthony, 2024. "Sources of specialist physician fee variation: Evidence from Australian health insurance claims data," Health Policy, Elsevier, vol. 147(C).
    8. Agha, Leila & Frandsen, Brigham & Rebitzer, James B., 2019. "Fragmented division of labor and healthcare costs: Evidence from moves across regions," Journal of Public Economics, Elsevier, vol. 169(C), pages 144-159.
    9. Benjamin R. Handel & Jonathan T. Kolstad, 2021. "The Affordable Care Act After a Decade: Industrial Organization of the Insurance Exchanges," NBER Working Papers 29178, National Bureau of Economic Research, Inc.
    10. Leila Agha & Keith Marzilli Ericson & Xiaoxi Zhao, 2020. "The Impact of Organizational Boundaries on Healthcare Coordination and Utilization," NBER Working Papers 28179, National Bureau of Economic Research, Inc.
    11. Zack Cooper & Stuart V Craig & Martin Gaynor & John Van Reenen, 2019. "The Price Ain’t Right? Hospital Prices and Health Spending on the Privately Insured," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 134(1), pages 51-107.
    12. Dillender, Marcus & Jinks, Lu & Lo Sasso, Anthony T., 2023. "When (and why) providers do not respond to changes in reimbursement rates," Journal of Public Economics, Elsevier, vol. 217(C).
    13. Christian Posso & Jorge Tamayo & Arlen Guarin & Estefania Saravia, 2024. "Luck of the Draw: The Causal Effect of Physicians on Birth Outcomes," Borradores de Economia 1269, Banco de la Republica de Colombia.
    14. David Card & Alessandra Fenizia & David Silver, 2023. "The Health Impacts of Hospital Delivery Practices," American Economic Journal: Economic Policy, American Economic Association, vol. 15(2), pages 42-81, May.
    15. Joshua D. Gottlieb & Maria Polyakova & Kevin Rinz & Hugh Shiplett & Victoria Udalova, 2023. "Who Values Human Capitalists' Human Capital? The Earnings and Labor Supply of U.S. Physicians," NBER Working Papers 31469, National Bureau of Economic Research, Inc.
    16. Geruso, Michael & Richards, Michael R., 2022. "Trading spaces: Medicare's regulatory spillovers on treatment setting for non-Medicare patients," Journal of Health Economics, Elsevier, vol. 84(C).
    17. Lundborg, Petter & James, Stefan & Lagerqvist, Bo & Vikström, Johan, 2021. "Learning-by-Doing and Productivity Growth among High-Skilled Workers: Evidence from the Treatment of Heart Attacks," IZA Discussion Papers 14744, Institute of Labor Economics (IZA).
    18. Ketcham, Jonathan & Kuminoff, Nicolai & Saha, Nirman, 2023. "Valuing Statistical Life Using Seniors' Medical Spending," RFF Working Paper Series 23-16, Resources for the Future.
    19. Kevin Callison & Robert Kaestner & Jason Ward, 2021. "Do Supply‐Side Forces Explain Geographic Variation In Health Care Use?," Economic Inquiry, Western Economic Association International, vol. 59(1), pages 119-139, January.
    20. Shan Huang & Hannes Ullrich, 2023. "Provider effects in antibiotic prescribing: Evidence from physician exits," Berlin School of Economics Discussion Papers 0018, Berlin School of Economics.

    More about this item

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:nbr:nberwo:33090. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: the person in charge (email available below). General contact details of provider: https://edirc.repec.org/data/nberrus.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.