Medicare Pricing Mechanisms for Physician Services: An Overview of Alternative Approaches

American Council of Life Insurance (1983). Statistical Bulletin, No. 83-2. Washington, D.C. : The Council, September 16.

American Medical Association (1984). Socioeconomic Characteristics of Medical Practice, 1984, eds. R. A. Reynolds and R. A. Ohsfeldt. Chicago: The Association .

Apagos, A.M. , and Gallaway, L.E. (1970). "Defense Profits and the Renegotiation Board in the Aerospace Industry," J. of Political Economy 78 (September/ October): 1093-1105.

Averch, H. , and Johnson, L.L. (1962). "Behavior of the Firm under a Regulatory Constraint ," American Economic Review 52 (December): 1052-69.

Breyer, S. (1982). Regulation and Its Reform. Cambridge: Harvard University Press.

Brimmer, A.F. (1962). "Price Determination in the United States Treasury Bill Market," Review of Economics and Statistics 44 (May): 178-83.

Burney, I.L. ; Schieber, G.J. ; Blaxall, M.O. ; and Gabel, J.R. (1979). "Medicare and Medicaid Physician Payment Incentives ," Health Care Financing Review 1 (Summer): 62-78.

Bums, A.E. (1972). "Profit Limitation: Regulated Industries and the Defense-Space Industries," Bell J. of Economics and Management Science 3 (Spring): 3-25.

Burstein, P.L. , and Cromwell, J. (1985). "Relative Incomes and Rates of Return for U.S. Physicians," J. of Health Economics 4 (March): 63-78.

Cafferata, G.L. (1984). Private Health Insurance Coverage of the Medicare Population. NCHSR National Health Care Expenditures Study Data Preview 18, DHHS Publication No. (PHS) 84-3362. Rockville, Md.: National Center for Health Services Research, September.

Center for Health Economics Research (1984 ). "Creating DRG-Based Physician Reimbursement: A Conceptual and Empirical Analysis." Year 1 Report on HCFA Grant No. 18-P-98387/1. Chestnut Hill, Mass.: The Center, October.

Chartoff, J. ; Mayo, G.W. ; and Smith, W.A. (1982). "The Case against the Use of the Capital Asset Pricing Model in Public Utility Ratemaking," Energy Law J. 3 (No. 1): 67-93.

Christianson, J.B. ; Smith, K.R. ; and Hillman, D.G. (1984). "A Comparison of Existing and Alternative Competitive Bidding Systems for Indigent Medical Care," Social Science & Medicine 18 (No. 7): 599-604.

Civil Aeronautics Board, Office of Economic Analysis (1982). Competition and the Airlines: An Evaluation of Deregulation. Washington, D.C.: The Board, December.

Commerce Clearinghouse ( 1985). Medicare-Medicaid Guide. Chicago: CCH.

Crew, M. (1969). "Coinsurance and the Welfare Economics of Medical Care," American Economic Review 59 (December): 906-8.

Eggers, P.W. , and Prihoda, R. (1982). "Pre-Enrollment Reimbursement Patterns of Medicare Beneficiaries Enrolled in 'At-Risk' HMOs," Health Care Financing Review 4 (September): 55-73.

Eisenberg, B.S. (1980). "Information Exchange among Competitors: The Issue of Relative Value Scales for Physicians' Services," J. of Law and Economics 23 (October): 441-60.

Enthoven, A.C. (1983). Consumer Choice Health Plan. Reading, Mass.: Addison-Wesley.

Evans, F.O. , Jr. (1980). "Physician-Based Group Insurance: A Proposal for Medical Cost Control," New England J. of Medicine 302 (June 5): 1280-83.

Fleisher, B.M. , and Kniesner, T.J. (1984). Labor Economics: Theory and Evidence. Englewood Cliffs, N.J.: Prentice-Hall.

Freeman, R.B. (1976). The Overeducated American. New York: Academic Press.

Friedman, M. (1963). "Price Determination in the United States Treasury Bill Market: A Comment," Review of Economics and Statistics 45 (August): 318-20.

Gabel, J.R. , and Monheit, A.C. (1983). "Will Competition Plans Change Insurer-Provider Relationships?" Health and Society: Milbank Memorial Fund Quarterly 61 (Fall): 614-40.

Gellhom, E. , and Pierce, R.J. , Jr. (1982). Regulated Industries St. Paul: West Publishing.

Gibson, R.M. ; Levit, K.R. ; Lazenby, H. ; and Waldo, D.R. (1984). "National Health Expenditures, 1983," Health Care Financing Review 6 (Winter): 1-29.

Glaser, W.A. (1978). Health Insurance Bargaining: Foreign Lessons for Americans. New York: Gardner Press .

Hadley, J. , and Berenson, R. (1985). "Seeking the 'Just' Price: Relative Value Scales and Fee Schedules for Physicians' Services." In Final Report on Alternative Methods of Developing a Relative Value Scale of Physicians' Services, by J. Hadley, D. A. Juba, R. Berenson, and M. B. Sulvetta, 91-139. Report on HCFA Contract No. 500-81-0053. Washington, D.C. : Urban Institute, April.

Havighurst, C.C. , and Kissam, P.C. (1979). "The Antitrust Implications of Relative Value Studies in Medicine," J. of Health Politics, Policy and Law 4 (Spring): 48-86.

Hay, J.W. (1983). "An Incentive Reimbursement Plan for Medicaid Home Health Care Services." Project proposal for Robert Wood Johnson Foundation Grant No. 9028, Princeton, N.J.

Health Care Financing Administration (1978 ). Medicare Directory of Prevailing Charges. MAB Publication No. 035 (4-78). Washington, D.C.: Government Printing Office.

Holahan, J. , and Scanlon, W. (1978). Price Controls, Physician Fees, and Physician Incomes from Medicare and Medicaid. Washington, D.C.: Urban Institute.

Howe, K.M. , and Rasmussen, E.F. (1982). Public Utility Economics and Finance. Englewood Cliffs, N.J.: Prentice-Hall.

Hsiao, W.C. , and Stason, W.B. (1979). "Toward Developing a Relative Value Scale for Medical and Surgical Services," Health Care Financing Review 1 (Fall): 23-38.

Hughes, E.F.X. ; Fuchs, V.R. ; Jacoby, J.E. ; and Lewit, E.M. (1972). "Surgical Work Loads in a Community Practice," Surgery 71 (March): 315-27.

Joskow, P.L. (1983). "Reimbursement Policy, Cost Containment and Non-Price Competition," J. of Health Economics 2 (August): 168-74.

Juba, D.A. (1985). "The Effects of Health Insurance on Absolute and Relative Prices of Physicians' Services." In Final Report on Alternative Methods of Developing a Relative Value Scale of Physicians' Services , by J. Hadley, D. A. Juba, R. Berenson, and M. B. Sulvetta, 56-90. Report on HCFA Contract No. 500-81-0053. Washington, D.C.: Urban Institute, April.

Juba, D.A. , and Sulvetta, M.B. (1985). "The Financial Effects of an RVS-Based Medicare Fee Schedule." In Final Report on Alternative Methods of Developing a Relative Value Scale of Physicians' Services, by J. Hadley, D. A. Juba, R. Berenson, and M. B. Sulvetta, 42-55. Report on HCFA Contract No. 500-81-0053. Washington, D.C.: Urban Institute , April.

Milgrom, P.R. (1979). "A Convergence Theorem for Competitive Bidding with Differential Information," Econometrica 47 (May): 679-88.

Munch, P. (1980). Economic Factors in the Use of Laboratory Tests by Office-Based Physicians. Rand Publication No. R-2525- HCFA. Santa Monica: Rand Corp. , April.

Navarro, P. ; Petersen, B.C. ; and Stauffer, T.R. (1981). "A Critical Comparison of Utility-Type Ratemaking Methodologies in Oil Pipeline Regulation," Bell J. of Economics 12 (Autumn): 392-412.

Newhouse, J.P. ; Manning, W.G. ; Morris, C.N. ; Orr, L.N. ; Duan, N. ; Keeler, E.B. ; Leibowitz, A. ; Marquis, K.H. ; Marquis, M.S. ; Phelps, C.E. ; and Brook, R.H. (1981). "Some Interim Results from a Controlled Trial of Cost Sharing in Health Insurance," New England J. of Medicine 305 (December 17): 1501-7.

Oren, M.E. , and Williams, A.C. (1975). "On Competitive Bidding," Operations Research 23 (November-December): 1072-79.

Palmer, R.H. , and Reilly, M.C. (1979). "Individual and Institutional Variables Which May Serve as Indicators of Quality of Medical Care," Medical Care 17 (July): 693-717.

Payne, B.C. ; Lyons, T.F. ; and Neuhaus, E. (1984). "Relationships of Physician Characteristics to Performance Quality and Improvement," Health Services Research 19 (August): 307-32.

Peck, M.J. , and Scherer, F.M. (1962). The Weapons Acquisition Process: An Economic Analysis . Boston: Graduate School of Business Administration, Harvard University.

Pettway, R.H. (1978). "On the Use of Beta in Regulatory Proceedings: An Empirical Examination," Bell J. of Economics 9 (Spring): 239-48.

Pfizenmayer, R.F. (1982). "Antitrust Law and Collective Physician Negotiations with Third Parties: The Relative Value Guide Object Lesson," J. of Health Politics, Policy and Law 7 (Spring): 128-62.

Reinhardt, U.E. (1981). "Health Insurance and Health Policy in the Federal Republic of Germany," Health Care Financing Review 3 (December): 1-14.

_. ( 1984). "Theoretical Perspectives on Physician Compensation." Unpublished paper.

Rice, T. , and McCall, N. (1985). "The Extent of Ownership and the Characteristics of Medicare Supplemental Policies," Inquiry 22 (Summer): 188-200.

Rodgers, J.F. , and Musacchio, R.A. (1983). "Physician Acceptance of Medicare Patients on Assignment," J. of Health Economics 2 (March): 55-73.

Scherer, F.M. (1964). The Weapons Acquisition Process: Economic Incentives . Cambridge: Harvard University Press.

Simborg, D.W. (1981). "DRG Creep: A New Hospital-Acquired Disease," New England J. of Medicine 304 (June 25): 1602-4.

Sloan, F.A. (1982). "Effects of Health Insurance on Physicians' Fees ," J. of Human Resources 17 (Fall): 533-57.

_. ( 1984). "Physicians and Hospitals: Implications of an Expanding Physician Supply." In The Coming Physician Surplus: In Search of a Public Policy, eds. E. Ginzberg and M. Ostow , 99-115. Totowa, N.J. : Rowman & Allenheld.

Sloan, F.A. , and Schwartz, W.B. (1983). "More Doctors: What Will They Cost?" J. of the American Medical Association 249 (February 11): 766-69.

Smith, V.L. (1966). "Bidding Theory and the Treasury Bill Auction: Does Price Discrimination Increase Bill Prices?" Review of Economics and Statistics 48 (May): 141-46.

. ( 1967). "Experimental Studies of Discrimination versus Competition in Sealed Bid Auction Markets," J. of Business 40 (January): 56-86.

, ed. ( 1982). Research in Experimental Economics. Vol. 2. Greenwich, Conn.: JAI Press.

Smits, H.L. , and Watson, R.E. (1984). "DRGs and the Future of Surgical Practice," New England J. of Medicine 311 (December 20): 1612-15.

Steinwald, B. (1980). "Hospital-Based Physicians: Current Issues and Descriptive Evidence," Health Care Financing Review 2 (Summer): 63-75.

Sweeney, G.H. (1982). "The Market for Physicians' Services: Theoretical Implications and an Empirical Test of the Target Income Hypothesis," Southern Economic J. 48 (January): 594-613.

Valvona, J. , and Sloan, F.A. (1985). "Rising Rates of Surgery among the Elderly," Health Affairs 4 (Fall): 108-19.

Wilson, R. (1977). "A Bidding Model of Perfect Competition," Review of Economic Studies 44 (February): 511-18.

Yett, D.E. ; Der, W. ; Ernst, R.L. ; and Hay, J.W. (1981). "Blue Shield Plan Physician Participation," Health Care Financing Review 2 (Spring): 9-24.