Access to medicare physician services

By Stephen Zuckerman

Subjects: Medicare, Physician services utilization, Medical fees

Description: This report presents findings of three analyses of access to physician services by Medicare beneficiaries since the implementation of physician payment reform. "Trends in volume and intensity of physician under the Medicare Fee Schedule : 1986-1994" shows that the growth in the volume and intensity of Medicare physician services slowed dramatically during the first three years of the Medicare Fee Schedule as compared to the preceding five-year period. "Price controls and Medicare spending: Assessing the volume offset assumption" estimates volume offsets in response to payment changes. This task examines price changes during period 1986 through 1992 across the full range of Medicare physician services. The estimated average volume offset is 19 percent, although significant variation exists by both type of service and physician speciality. "Health care utilization among beneficiaries : demographic and socioeconomic differences and the implications for equitable access" re-examines the question of access differentials among Medicare beneficiaries to determine what differences exist by age, urbanicity, race, income, and/or living arrangements. Utilization rates were found to be lower for African American beneficiaries, low income beneficiaries and those with lower educational attainment. Utilization rates increased with age and were higher for those living alone compared to those living with a spouse. --NTIS report documentation page.