Biomedical subjects
J Hadley
Publications and source records attributed to J Hadley.
Changing an employee's conditions.
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Effects of financial incentives on physicians' specialty and location decisions.
Available information is reviewed on the effects of financial incentives on physicians' specialty and location decisions. Income of physicians varies by specialty and geographic area, but evidence is limited on the effects of these differences on career decisions. Only two studies have been done on the relationship of oncome to specialty choice. These studies showed that the impact of income on specialty choice, if any, is weak. Studies on the relationship of both reimbursement levels and income to physician location choice generally concluded that there is a small, positive correlation between these financial factors and physician density. Thus, increasing physicians' income appears to be viable public policy for attracting physicians to underserved areas. Though rough estimates are calculated of the cost of attracting additional physicians, based on studies reviewed, conclusions on costs of incentive programs are premature.
National health insurance and the new health occupations: nurse practitioners and physicians' assistants.
This article considers a number of issues which might arise in formulating policy for new health occupations. Its particular focus is on nurse practitioners and physicians' assistants and their treatment under potential national health insurance arrangements. The development and expansion of these occupations are described, as is the evidence on their performance with respect to the quality of medical care provided, the impact on the cost of such care, and changes in access to care. We then discuss several issues which might arise in the context of national health insurance legislation, including reimbursement rates and methods, certification and licensure, training subsidies, deployment incentives, and compatibility with an increased supply of physicians.
Who carries the can?
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Alternative methods of evaluating health manpower distribution.
Four desirable characteristics of an ideal method of evaluating health manpower distribution are postulated. Current approaches are evaluated using these criteria and are shown to be unsatisfactory. An alternative method, based on the economic theory of production, is then described. The paper concludes with some recommendations for further research.
A disaggregated model of medical specialty choice.
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Can fee-for-service reimbursement coexist with demand creation?
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Paying for physician services under Medicare and Medicaid.
Public systems for physician reimbursement aim to reconcile two disparate objectives: ensuring availability of services to the poor and aged; and keeping rates of cost increase within acceptable limits. Several interesting--and unorthodox--policy simulations of physician pricing behavior are investigated through econometric estimation. Current arrangement for paying physicians are fraught with difficulties. The objectives of Medicare and Medicaid are not well served.
Physician participation in Medicaid: evidence from California.
The objective of this paper is to investigate physician participation in the Medicaid program. In particular, how sensitive is the physician's involvement with Medicaid to variations in Medicaid reimbursements? How important are fee levels in the private market? What is the impact of inflation on the costs of physicians' inputs, particularly if the Medicaid fee remains relatively constant? These questions are explored through an empirical analysis fo data from the California Medicaid program. Two aspects of physician participation form the focus of the study: 1) the percentage of physicians participating in Medicaid in a given county and 2) the average number of nonaged, Medicaid patients treated by each participating physician. Information on these variables and on Medicaid fees and private charges come from Medicare and Medicaid claims records for more than 3,000 physicians. The most significant result of the study is the reaffirmation of the importance of the amounts of both private charges and Medicaid payments in determining participation rates and average Medicaid case loads per participating physician. Both dependent variables are, as expected, inversely related to physicians' average billed revenue per patient and are positively related to average Medicaid payments per patient. In addition, it appears that the long-run impact of a change in billed revenue is significantly larger in absolute value than a corresponding change in the amount that Medicaid is willing to pay.
Practice management. Your employees' sickness.
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Practice management. What is your responsibility?
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Be careful what you say.
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Part-time and fixed term staff.
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Dismissal of employees.
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