Equalizing Physician Fees had Little Effect on Cesarean Rates

Higher physician fees for cesarean delivery have been hypothesized to increase cesarean rates, but there are few published estimates of their effect. We studied the impact of an insurance reform that equalized fees for vaginal and cesarean delivery, a relative price shift of 21%. After adjusting for...

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Bibliographic Details
Published in:Medical care research and review 1996-12, Vol.53 (4), p.465-471
Main Authors: Keeler, Emmett B., Fok, Thomas
Format: Article
Language:English
Subjects:
Births
Blue Cross Blue Shield Insurance Plans - economics
Blue Cross Blue Shield Insurance Plans - standards
Caesarean section
California
Cesarean section
Cesarean Section - economics
Cesarean Section - utilization
Delivery, Obstetric - economics
Delivery, Obstetric - methods
Doctors
Factors
Fee Schedules - standards
Fees
Female
Health administration
Health Care Reform
Health insurance
Health Services Research
Humans
Obstetrics - economics
Physicians
Preferred Provider Organizations - economics
Preferred Provider Organizations - standards
Pregnancy
Professional fees
Rate Setting and Review
Reforms
USA
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Summary:Higher physician fees for cesarean delivery have been hypothesized to increase cesarean rates, but there are few published estimates of their effect. We studied the impact of an insurance reform that equalized fees for vaginal and cesarean delivery, a relative price shift of 21%. After adjusting for case-mix, cesarean rates were calculated from data on the 11,767 deliveries in the 12 months before and after the reform. Overall, there was a 0.7% nonsignificant drop after the reform. The drop was apparently due to the departure of physicians with few deliveries paid by the plan, but high cesarean rates. Despite the limited impact on cesarean rates, equalizing fees may be beneficial because physician costs are similar for the two procedures.
ISSN:1077-5587
1552-6801
DOI:10.1177/107755879605300405