Medical research and health care finance: Evidence from Academic Medical Centers
研究了1997年美国《平衡预算法案》减少对学术医疗中心（AMCs）的医保报销后，这些机构如何通过增加研究活动（约6%）和调整人员招聘来应对，对临床结果影响不大。
Academic Medical Centers (AMCs) — comprising medical schools, teaching hospitals, and research laboratories — play an important role in US biomedical innovation. The Balanced Budget Act of 1997 changed reimbursements for Medicare inpatient claims and subsidies for medical residents. We compare AMCs’ relative exposure to the reform, how these differences affect their researchers’ ability to attract NIH grant funding, and the quantity, impact, and content of their publications. We find that in response to the reform, research activity increased by approximately 6%. Changes in research composition suggest that hospitals responded to Medicare funding cuts by encouraging incumbent investigators to increase their research activities and by redirecting hiring efforts towards individuals attracted to AMCs (e.g., translational researchers). We find little effect on clinical outcomes. • We study how research institutions adjust innovation in response to financing shocks. • Academic Medical Centers (AMCs) play a central role in biomedical innovation. • In 1997, a health care reform reduced patient care reimbursements within AMCs. • AMCs adapted by adjusting hiring and shifting from patient care to clinical research.