Physician Fee Policy and Medicaid Program Costs
利用田纳西州医疗补助计划中医生费用大幅上涨的政策变化，以佐治亚州为对照，检验增加贫困人群就医机会是否能将护理从医院门诊转移并降低医疗补助成本。研究发现护理从诊所转向医生办公室，但未从医院门诊或急诊转移，住院支出下降使总支出减少8%，但无法证明与费用变化的因果关系。
We investigate the hypothesis that increasing access for the indigent to physician offices shifts care from hospital outpatient settings and lowers Medicaid costs (the so-called offset effect'). To evaluate this hypothesis we exploit a large increase in physician fees in the Tennessee Medicaid program, using Georgia as a control. We find that beneficiaries shifted care from clinics to offices, but that there was little or no shifting from hospital outpatient departments or emergency rooms. Thus, we find no offset effect in outpatient expenditures. Inpatient admissions and expenditures fell, reducing overall program spending eight percent. Because the inpatient reduction did not occur in ambulatory-care-sensitive diagnoses, however, we cannot demonstrate a causal relationship with the fee change.