Laboratory Test Ordering by Physicians: The Effect of Reimbursement PoliciesThe use of laboratory tests has more than doubled during the past decade. This study investigates the importance of several reimbursement factors in the frequency of test ordering by office-based physicians. The number of laboratory tests ordered per visit is not related to the level of the patient's insurance coverage. Despite this, more generous insurance coverage for ambulatory care would lead to an increase in total test volumes, because physician visit rates have been shown elsewhere to be strongly influenced by the amount of patient cost sharing for medical care. Physicians who control test billing are more likely to order tests than physicians who refer their patients to laboratories that bill directly. However, testing in-house and controlling test billing may be the result of a high anticipated volume of tests rather than the cause of a higher test ordering frequency. The author concludes that direct billing regulations are not likely to result in significant reductions in total health care costs. The marginal cost of the tests is far below their average costs, so that very large reductions in test volumes would be required to achieve significant cost savings. |
Contents
TRENDS IN WORLD OIL USETHE BACKGROUND | 1 |
DATA AND METHODS | 7 |
EMPIRICAL RESULTS | 14 |
Copyright | |
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actions billing arrangements California Energy Commission Clean Air Act coefficient coinsurance control test billing cost Crude Oil Danzon decisionmakers direct billing economic effects energy crisis management energy emergency FAA recommended federal government frequency of test game results gasoline Health heating oil implement increase internists intracluster correlation Japan laboratories that bill laboratory tests legislation MMBD MOVE PERIOD Natural Gas Newhouse number of laboratory number of tests OAPEC oil supply disruption oil-producing nations OPEC ordering per visit participants patients pediatricians percent petroleum products phase physicians players practitioners President price and allocation price of tests probability of ordering purchased tests Rand Corporation rebate policy reported represented responses scenario selected diagnoses setaside significant solo practice specialists specific tests standby supply price t-Statistic Table teams test ordering test-ordering decisions tests in-house tests per visit tests performed U.S. Department United Urinalysis Variable Coeff visits by adults visits by children