Working Paper: NBER ID: w17070
Authors: Craig L. Garthwaite
Abstract: In the United States, public health insurance programs cover over 90 million individuals. Changes in the scope of these programs, such as the Medicaid expansions under the recently passed Patient Protection and Affordable Care Act, may have large effects on physician behavior. This study finds that following the implementation of the State Children's Health Insurance Program, physicians decreased the number of hours spent with patients, but increased their participation in the expanded program. Suggestive evidence is found that this decrease in hours was a result of shorter office visits. These findings are consistent with the predictions from a mixed-economy model of physician behavior with public and private payers and also provide evidence of crowd out resulting from the creation of SCHIP.
Keywords: public health insurance; physician behavior; labor supply; Medicaid; SCHIP
JEL Codes: H0; H4; I1; I18
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| implementation of SCHIP (I18) | decrease in hours spent on patient care by pediatricians (J22) |
| increase in simulated Medicaid eligibility (I18) | decrease in hours spent on patient care by pediatricians (J22) |
| implementation of SCHIP (I18) | increase in percentage of pediatricians accepting new Medicaid patients (I18) |
| implementation of SCHIP (I18) | decrease in visit durations for Medicaid patients (I18) |
| decrease in hours spent on patient care by pediatricians (J22) | decrease in labor supply (J20) |