Physician Group Influences on Treatment Intensity and Health: Evidence from Physician Switchers

51 Pages Posted: 3 Jan 2022 Last revised: 1 Jun 2022

See all articles by Joseph J. Doyle

Joseph J. Doyle

Massachusetts Institute of Technology (MIT) - Economics, Finance, Accounting (EFA); National Bureau of Economic Research (NBER)

Becky Staiger

Stanford School of Medicine

Date Written: December 2021

Abstract

Treatment intensity varies remarkably across physicians, yet the key drivers are not well understood. Meanwhile, the organization of healthcare is undergoing a secular transformation as physicians increasingly work in groups. This paper tests whether physicians' group affiliation matters for practice styles and patient health. Using Medicare inpatient claims data, we compare these outcomes before and after physicians switch between groups of varying treatment intensity while remaining in the same hospital to control for practice setting. Event studies show that internists who join more-intensive groups immediately increase their own treatment intensity, with an elasticity of approximately 0.3; the opposite is found for internists who switch to groups that are less intensive. This change in Medicare spending largely stems from greater quantities of care provided, with some evidence of a change in coding behavior. We do not detect a change in health outcomes, suggesting that treatment intensity induced by group affiliation may not be productive.

Suggested Citation

Doyle, Joseph John and Staiger, Becky, Physician Group Influences on Treatment Intensity and Health: Evidence from Physician Switchers (December 2021). NBER Working Paper No. w29613, Available at SSRN: https://ssrn.com/abstract=3998786

Joseph John Doyle (Contact Author)

Massachusetts Institute of Technology (MIT) - Economics, Finance, Accounting (EFA) ( email )

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National Bureau of Economic Research (NBER)

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Becky Staiger

Stanford School of Medicine ( email )

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