TAILIEUCHUNG - Lecture Health economics - Chapter 8: The physician market (Part 1)

Lecture Health economics - Chapter 8: The physician market (Part 1). This chapter presents the following content: Physician market structure, conduct in the physician market, physician market performance, physician practice management companies. | The Physician Market, Part 1 Professor Vivian Ho Health Economics Fall 2009 These slides summarize material in Santerre & Neun: Health Economics, Theories Insights and Industry Studies, Southwestern Cengate 2010 OUTLINE Physician Market Structure Conduct in the Physician Market Physician Market Performance Physician Practice Management Companies Physician Market Structure *The AMA defines primary care as including family practice, general practice, internal medicine, obstetrics/gynecology, and pediatrics. Physician Market Structure (cont.) 2006 data is from the Physician Compensation & Production Survey 2007 Report Are there “too many” specialists and “too few” primary care docs? Proportion of specialists in . higher than in W. European countries and Canada (60% vs. 25-50%). Specialists more prone to use new, high-tech medical procedues. May explain why . medical costs per capita are highest in the world. Matching Physician Supply & Requirements “Future physician supply does not appear well-matched with requirements. (Politzer, 1996) A shortage of 33,000 primary care physicians is predicted by 2020. The same set of assumptions also generates a surplus of specialists. Distribution of Physicians by Mode of Practice Most docs self-employed, but % is dropping. Fall in solo practice docs, rise in salaried docs. Reflects rise in ambulatory care by HMOs. AMA Physician Marketplace Report Size of practice numbers don’t sum to 100. This is because these are broken down only for practices owned by MDs. The missing proportion is for % of practices not owned by MDs. Distribution of Physician Revenues by Source of Payer % of revenues from Medicare/Medicaid high, but lower than for hospital sector. % of revenues paid out-of-pocket also higher than for hospital sector. Used NHE Expenditure data to compute 2005, but checked with 2002 and 1980 and these mirror the

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