Malpractice Insurance Costs and Physician Practice, 1983-1986

Rosenbach, Margo; Stone, Ashley G.

doi:10.1377/hlthaff.9.4.176

Cited by 5 publications

(2 citation statements)

References 1 publication

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“…The resource-based relative value system (RBRVS) that Medicare developed had little choice but to pay more for services with higher input costs, and malpractice insurance is a very high input cost for certain procedural specialties (Ginsburg et al 1990;Rosenbach and Stone 1990). The RBRVS formula, including the malpractice component, now influences physician payment in conjunction with Congressional limits on total physician fees paid by Medicare (the "sustainable growth rate").…”

Section: Provider Reimbursementmentioning

confidence: 99%

Both Symptom and Disease: Relating Medical Malpractice to Health-Care Costs

Sage

2012

Forum for Health Economics &Amp; Policy

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Tort reformers blame the high cost of American health care on defensive responses to rampant medical malpractice litigation. Defenders of the tort system counter that holding health care providers liable for negligence improves safety and ensures compensation for injury. The relationship between medical malpractice and health care expenditures is more complex than either of these positions reflects. The existing medical malpractice system increases medical spending mainly because it has evolved in tandem with other inflationary features of the health care system and may make those features even more difficult to change. In other words, medical malpractice is both a symptom of a costly health care system and a costly disease in its own right.

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Section: Provider Reimbursementmentioning

confidence: 99%

Both Symptom and Disease: Relating Medical Malpractice to Health-Care Costs

Sage

2012

Forum for Health Economics &Amp; Policy

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“…According to the results of a national sample of physicians surveyed in 1984, urban physicians were 2.6 times more likely than rural physicians to participate in HMOs and PPOs (36 percent vs. 14 percent) (Rosenbach, et al, 1988). When physicians with no HMO or PPO in their area were excluded, the difference in participation rates narrowed but remained significant at 45 percent for urban physicians vs. 32 percent for rural physicians.…”

Section: Introductionmentioning

confidence: 99%

Research on Managed Care Organizations in Rural Communities

Krein

Casey²

1998

The Journal of Rural Health

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Preserving the Physician-Patient Relationship in the Era of Managed Care

Emanuel

Dubler²

1995

JAMA

282

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Even without comprehensive health care reform legislation, the US health care system is undergoing significant changes. Probably the most important change is the expansion of managed care with significant price competition. One of the major concerns about this change is the effect of managed care on the physician-patient relationship. To provide a normative standard for evaluating the effect of changes, we need an ideal conception of the physician-patient relationship. This ideal can be summarized by six C's: choice, competence, communication, compassion, continuity, and (no) conflict of interest. For the 37 million uninsured Americans there is little chance of realizing the ideal physician-patient relationship, since they lack the choice of practice setting and physician, receive care in a rushed atmosphere that undermines communication and compassion, and have no continuity of care. While many insured Americans may believe they have an ideal physician-patient relationship, the relationship is threatened by lack of a regular assessment of competence, by financial incentives that undermine good communication, and by the persistence of conflict of interest. The shift to managed care may improve the choice of practice settings, especially in sections of the country that currently lack managed care; increase choice of preventive services; make quality assessments more routine; and improve communication by making greater use of primary care physicians and nonphysician providers. However, the expansion of managed care and the imposition of significant cost control have the potential to undermine all aspects of the ideal physician-patient relationship. Choice could be restricted by employers and by managed care selection of physicians; poor quality indicators could undermine assessments of competence; conductivity requirements could eliminate time necessary for communication; changing from one to another managed care plan to secure the lowest costs could produce significant disruption in continuity of care; and use of salary schemes that reward physicians for not using medical services could increase conflict of interest.

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Malpractice Insurance Costs and Physician Practice, 1983-1986

Cited by 5 publications

References 1 publication

Both Symptom and Disease: Relating Medical Malpractice to Health-Care Costs

Both Symptom and Disease: Relating Medical Malpractice to Health-Care Costs

Research on Managed Care Organizations in Rural Communities

Preserving the Physician-Patient Relationship in the Era of Managed Care

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