Physician responses to insurance benefit restrictions: The case of ophthalmology

Olukorede Abiona, Philip Haywood, Serena Yu, Jane Hall, Denzil G. Fiebig, Kees van Gool

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Abstract

This study examines the impact of social insurance benefit restrictions on physician behaviour, using ophthalmologists as a case study. We examine whether ophthalmologists use their market power to alter their fees and rebates across services to compensate for potential policy-induced income losses. The results show that ophthalmologists substantially reduced their fees and rebates for services directly targeted by the benefit restriction compared to other medical specialists' fees and rebates. There is also some evidence that they increased their fees for services that were not targeted. High-fee charging ophthalmologists exhibited larger fee and rebate responses while the low-fee charging group raise their rebates to match the reference price provided by the policy environment.
Original languageEnglish
Pages (from-to)911-928
Number of pages18
JournalHealth Economics (United Kingdom)
Volume33
Issue number5
Early online date22 Jan 2024
DOIs
Publication statusPublished - May 2024

Bibliographical note

© 2024 The Authors. Health Economics published by John Wiley & Sons Ltd. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

Keywords

  • health insurance
  • ophthalmology
  • physician fees
  • policy evaluation
  • reference prices

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