Primary Care Competition and Quality of Care: Empirical Evidence from Medicare

60 Pages Posted: 23 Aug 2018 Last revised: 19 Jun 2019

See all articles by Christopher Brunt

Christopher Brunt

Georgia Southern University - Department of Finance and Economics

Joshua R. Hendrickson

University of Mississippi; American Institute for Economic Research

John R. Bowblis

Miami University of Ohio - Department of Economics

Date Written: June 13, 2019

Abstract

This study explores the effects of primary care physician (PCP) practice competition on ten distinct quality metrics directly tied to screening, follow-up care, and prescribing behavior under Medicare Part B. Using ordered logit with two-stage residual inclusion to account for potential endogeneity between quality and PCP market concentration, this study finds strong evidence that PCP practices in more concentrated markets provide lower quality of care. More specifically, PCPs in more concentrated markets are less likely to perform screening and follow-up care for depression, tobacco use, and unhealthy body weight. Further, PCPs in more concentrated markets have a higher percentage of opioid prescriptions and a higher percentage of Part D beneficiaries with at least one opioid prescription.

Keywords: Primary Care Competition, Quality, Medicare Part B

JEL Classification: I11, L11

Suggested Citation

Brunt, Christopher and Hendrickson, Joshua R. and Bowblis, John R., Primary Care Competition and Quality of Care: Empirical Evidence from Medicare (June 13, 2019). Available at SSRN: https://ssrn.com/abstract=3229955 or http://dx.doi.org/10.2139/ssrn.3229955

Christopher Brunt

Georgia Southern University - Department of Finance and Economics ( email )

P.O. Box 815s
Statesboro, GA 30460
United States

Joshua R. Hendrickson (Contact Author)

University of Mississippi ( email )

Oxford, MS 38677
United States

American Institute for Economic Research

PO Box 1000
Great Barrington, MA 01230
United States

John R. Bowblis

Miami University of Ohio - Department of Economics ( email )

800 E. High St.
Farmer School of Business, 2054
Oxford, OH 45056
United States

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