Inquiry J Health Car
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Inquiry J Health Car · Jan 1993
Amending the National Practitioner Data Bank reporting requirements: are small claims predictive of large claims?
This study addresses whether a physician incurring small malpractice claims is predictive of large claims. This is one consideration behind reevaluating whether all claims that result in an indemnity payment should continue to be reported to the National Practitioner Data Bank, or whether claims with payments below some "floor" should be excluded. Using a claims database from 3,098 physicians for 1977-1986, both cross-sectional and longitudinal analyses show that an individual having a small claim (under $30,000) is indicative of a propensity to incur large claims. This finding is robust to the cutpoint between large and small claims.
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Inquiry J Health Car · Jan 1993
Comparative StudyPhysician responses to Medicare physician payment reform: preliminary results on access to care.
This paper examines the impact of Medicare physician payment reform on access to care by comparing several physician-based access measures in the pre- and post-reform periods. The results suggest that the broad goals of payment reform may have been at least partially achieved: the proportion of physician revenues derived from Medicare increased for primary care physicians and decreased for nonprimary care MDs; there was little change in the absolute or relative number of visits provided to Medicare patients; and an increasing number of physicians charged no more than the Medicare payment amount. ⋯ Fewer physicians were willing to treat all new Medicare patients and more physicians accepted no new Medicare patients. Furthermore, there was an increase in the proportion of physicians who reduced or stopped providing to Medicare patients certain types of services that they continued to provide to other patients.