Variation and Physician Agency

The goal for today’s class is to understand the literature on geographic variation in healthcare spending/utilization and some of the key papers in physician agency. Focus areas and selected papers are listed below:

Supply-side Variation

While there is substantial research documenting variation in healthcare spending and utilization, there is less consensus on the source of this variation. The first group of papers we’ll discuss today attempt to decompose variation in healthcare spending between demand and supply-side factors. We’ll focus on Finkelstein, Gentzkow, and Williams (2016) and Badinski et al. (2023) specifically. While these are relatively recent papers, the build on a much older literature studying variation in spending.

Physician Agency and Financial Incentives

While there are many papers studying this topic, we’ll discuss Iizuka (2012) and Clemens and Gottlieb (2014) in class. Iizuka (2012) considers prescribing behaviors in a unique setting where physicians can profit directly from different prescriptiond rugs. Clemens and Gottlieb (2014) examines the impact of an exogenous change in Medicare reimbursement rates on physician behavior.

References

Badinski, Ivan, Amy Finkelstein, Matthew Gentzkow, and Peter Hull. 2023. “Geographic Variation in Healthcare Utilization: The Role of Physicians.” Working {Paper}. Working Paper Series. National Bureau of Economic Research. https://doi.org/10.3386/w31749.
Clemens, Jeffrey, and Joshua D Gottlieb. 2014. “Do PhysiciansFinancial Incentives Affect Medical Treatment and Patient Health?” American Economic Review 104 (4): 1320–49.
Finkelstein, Amy, Matthew Gentzkow, and Heidi Williams. 2016. “Sources of Geographic Variation in Health Care: Evidence From Patient Migration.” The Quarterly Journal of Economics 131 (4): 1681–1726. https://ideas.repec.org//a/oup/qjecon/v131y2016i4p1681-1726..html.
Iizuka, Toshiaki. 2012. “Physician Agency and Adoption of Generic Pharmaceuticals.” American Economic Review 102 (6): 2826–58.