Working Paper: NBER ID: w20565
Authors: Laurence C Baker; Kate Bundorf; Daniel Kessler
Abstract: Although doctors and hospitals own their patients' medical records, state and federal laws require that they provide patients with a copy at "reasonable cost." We examine the effects of state laws that cap the fees that doctors and hospitals are allowed to charge patients for a copy of their records. We test whether these laws affected patients' propensity to switch doctors and the prices of new- and existing-patient visits. We also examine the effect of laws on hospitals' adoption of electronic medical record (EMR) systems. We find that patients from states adopting caps on copy fees were significantly more likely to switch doctors, and that hospitals in states adopting caps were significantly more likely to install an EMR. We also find that laws did not have a systematic, significant effect on prices.
Keywords: medical records; property rights; healthcare; EMR adoption; patient switching
JEL Codes: I1; I10; I11
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| Patient behavior (switching doctors) (I11) | EMR adoption by hospitals (I11) |
| State laws capping copying fees (D45) | Patient behavior (switching doctors) (I11) |
| State laws capping copying fees (D45) | EMR adoption by hospitals (I11) |
| State laws capping copying fees (D45) | Patient visit prices (I11) |