Do physician incentives affect hospital choice? A progress report

The US health reforms of March 2010 introduced new provisions for physicians providing Medicare and Medicaid services to be given financial incentives to control costs. Physician payment mechanisms generating similar incentives are currently used by some health maintenance organizations in California. We describe an ongoing research project in which we investigate physician responses to these payment schemes. The question is whether patients whose physicians have incentives to control hospital costs are admitted to lower-priced hospitals than other patients, all else equal. We provide an initial analysis of California hospital discharge data from 2003, documenting evidence consistent with this hypothesis.