{"id":"https://openalex.org/W2034872575","doi":"https://doi.org/10.1377/hlthaff.8.1.21","title":"The Medicare Physician Fee Freeze: What Really Happened?","display_name":"The Medicare Physician Fee Freeze: What Really Happened?","publication_year":1989,"publication_date":"1989-01-01","ids":{"openalex":"https://openalex.org/W2034872575","doi":"https://doi.org/10.1377/hlthaff.8.1.21","mag":"2034872575","pmid":"https://pubmed.ncbi.nlm.nih.gov/2651261"},"language":"en","primary_location":{"id":"doi:10.1377/hlthaff.8.1.21","doi":"https://doi.org/10.1377/hlthaff.8.1.21","is_oa":false,"landing_page_url":"https://doi.org/10.1377/hlthaff.8.1.21","pdf_url":null,"source":{"id":"https://openalex.org/S4210185023","display_name":"Health Affairs","issn_l":"0278-2715","issn":["0278-2715","1544-5208","2694-233X"],"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":["anvur-scientific","dongbi-a","doyens","fnege-2","jufo-2","medline","norway-1","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315983","host_organization_name":"Project HOPE","host_organization_lineage":["https://openalex.org/P4310315983"],"host_organization_lineage_names":["Project HOPE"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Health Affairs","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5011819192","display_name":"Janet B. Mitchell","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Janet B. Mitchell","raw_affiliation_strings":["ITHC UVP"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"ITHC UVP","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5003973360","display_name":"Gerard J. Wedig","orcid":"https://orcid.org/0000-0003-2345-4665","observed_orcids":["https://orcid.org/0000-0003-2345-4665"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Gerard Wedig","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"last","author":{"id":"https://openalex.org/A5114254127","display_name":"Jerry Cromwell","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Jerry Cromwell","raw_affiliation_strings":["RTI Fellow Program"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"RTI Fellow Program","institution_ids":[]}]}],"institutions":[],"countries_distinct_count":0,"institutions_distinct_count":0,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":25.3887,"has_fulltext":false,"cited_by_count":54,"citation_normalized_percentile":{"value":0.99538716,"is_in_top_1_percent":true,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":88,"max":97},"biblio":{"volume":"8","issue":"1","first_page":"21","last_page":"33"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10391","display_name":"Healthcare Policy and Management","score":0.9994999766349792,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},"topics":[{"id":"https://openalex.org/T10391","display_name":"Healthcare Policy and Management","score":0.9994999766349792,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T13555","display_name":"Healthcare cost, quality, practices","score":0.00019999999494757503,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11531","display_name":"Healthcare Systems and Reforms","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/fee-for-service","display_name":"fee-for-service","score":0.6970000267028809},{"id":"https://openalex.org/keywords/medicare-claims-data","display_name":"Medicare claims data","score":0.6100000143051147},{"id":"https://openalex.org/keywords/surgical-services","display_name":"surgical services","score":0.39100000262260437},{"id":"https://openalex.org/keywords/diagnostic-testing","display_name":"diagnostic testing","score":0.9459999799728394},{"id":"https://openalex.org/keywords/capitation","display_name":"capitation","score":0.44699999690055847},{"id":"https://openalex.org/keywords/centers-for-medicare-medicaid-services","display_name":"Centers for Medicare and Medicaid Services","score":0.6549999713897705}],"concepts":[{"id":"https://openalex.org/C29122968","wikidata":"https://www.wikidata.org/wiki/Q1414816","display_name":"Incentive","level":2,"score":0.6362866759300232},{"id":"https://openalex.org/C2776534028","wikidata":"https://www.wikidata.org/wiki/Q1141363","display_name":"Medicaid","level":3,"score":0.5030888915061951},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.4923444986343384},{"id":"https://openalex.org/C2777106239","wikidata":"https://www.wikidata.org/wiki/Q595094","display_name":"Sister","level":2,"score":0.4527084231376648},{"id":"https://openalex.org/C2776753347","wikidata":"https://www.wikidata.org/wiki/Q5441151","display_name":"Fee-for-service","level":3,"score":0.42277806997299194},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.4219772219657898},{"id":"https://openalex.org/C10138342","wikidata":"https://www.wikidata.org/wiki/Q43015","display_name":"Finance","level":1,"score":0.3622402846813202},{"id":"https://openalex.org/C144133560","wikidata":"https://www.wikidata.org/wiki/Q4830453","display_name":"Business","level":0,"score":0.3224174678325653},{"id":"https://openalex.org/C162324750","wikidata":"https://www.wikidata.org/wiki/Q8134","display_name":"Economics","level":0,"score":0.29217126965522766},{"id":"https://openalex.org/C17744445","wikidata":"https://www.wikidata.org/wiki/Q36442","display_name":"Political science","level":0,"score":0.21294370293617249},{"id":"https://openalex.org/C199539241","wikidata":"https://www.wikidata.org/wiki/Q7748","display_name":"Law","level":1,"score":0.14453715085983276},{"id":"https://openalex.org/C50522688","wikidata":"https://www.wikidata.org/wiki/Q189833","display_name":"Economic growth","level":1,"score":0.12179139256477356},{"id":"https://openalex.org/C175444787","wikidata":"https://www.wikidata.org/wiki/Q39072","display_name":"Microeconomics","level":1,"score":0.0}],"mesh":[{"descriptor_ui":"D000368","descriptor_name":"Aged","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D003430","descriptor_name":"Cross-Sectional Studies","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005251","descriptor_name":"Fees, Medical","qualifier_ui":"Q000639","qualifier_name":"trends","is_major_topic":true},{"descriptor_ui":"D006278","descriptor_name":"Medicare","qualifier_ui":"Q000191","qualifier_name":"economics","is_major_topic":true},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D007357","descriptor_name":"Insurance, Physician Services","qualifier_ui":"Q000191","qualifier_name":"economics","is_major_topic":true},{"descriptor_ui":"D011907","descriptor_name":"Rate Setting and Review","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D013997","descriptor_name":"Time Factors","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D014481","descriptor_name":"United States","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false}],"locations_count":2,"locations":[{"id":"doi:10.1377/hlthaff.8.1.21","doi":"https://doi.org/10.1377/hlthaff.8.1.21","is_oa":false,"landing_page_url":"https://doi.org/10.1377/hlthaff.8.1.21","pdf_url":null,"source":{"id":"https://openalex.org/S4210185023","display_name":"Health Affairs","issn_l":"0278-2715","issn":["0278-2715","1544-5208","2694-233X"],"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":["anvur-scientific","dongbi-a","doyens","fnege-2","jufo-2","medline","norway-1","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315983","host_organization_name":"Project HOPE","host_organization_lineage":["https://openalex.org/P4310315983"],"host_organization_lineage_names":["Project HOPE"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Health Affairs","raw_type":"journal-article"},{"id":"pmid:2651261","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/2651261","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Health affairs (Project Hope)","raw_type":"Journal Article"}],"best_oa_location":null,"sustainable_development_goals":[],"study_designs":[{"id":"https://openalex.org/study-designs/observational-study","display_name":"Observational Study"}],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":8,"referenced_works":["https://openalex.org/W566586761","https://openalex.org/W1980234102","https://openalex.org/W1995708368","https://openalex.org/W2021370618","https://openalex.org/W2032978497","https://openalex.org/W2053381688","https://openalex.org/W2407712509","https://openalex.org/W4234756424"],"related_works":["https://openalex.org/W2418379907","https://openalex.org/W2029480087","https://openalex.org/W2419910590","https://openalex.org/W2041493607","https://openalex.org/W7042221527","https://openalex.org/W4206771060","https://openalex.org/W2402147008","https://openalex.org/W2119790105","https://openalex.org/W2030465897","https://openalex.org/W7098214684"],"abstract_inverted_index":{"Prologue:":[0],"Physicians":[1],"and":[2,104,137,153,187,268,276],"patients":[3],"play":[4],"the":[5,10,28,37,114,139,142,147,151,171,177,204,221,231,271,303,314],"key":[6],"roles":[7],"in":[8,109,144,195,244,286,306],"determining":[9],"volume":[11],"of":[12,21,30,39,203,233,251,262,298],"medical":[13,31],"services":[14,122,166],"provided":[15,123],"by":[16,95,124,132,167],"practitioners.":[17],"Physicians,":[18],"as":[19,295],"agents":[20],"their":[22,263],"patients,":[23],"render":[24],"professional":[25],"judgments":[26],"regarding":[27],"use":[29],"services.":[32,98],"Professional":[33],"norms":[34],"call":[35],"for":[36,121,164,185,206,316],"provision":[38],"all":[40,128,145,261],"beneficial":[41],"services,":[42],"but":[43],"physicians":[44,89],"paid":[45,62],"on":[46,63,119],"a":[47,51,64,69,193,210,242,284,310],"fee-for-service":[48],"basis":[49],"have":[50,68,90],"financial":[52,70,82],"incentive":[53,71],"to":[54,60,72,92,141,230],"provide":[55],"more":[56,80,160],"service":[57],"(in":[58],"contrast":[59],"doctors":[61,133],"capitated":[65],"basis,":[66],"who":[67,191,240],"undertreat).":[73],"As":[74],"physician":[75,111,165],"practice":[76],"has":[77],"come":[78],"under":[79],"intense":[81],"pressure,":[83],"there":[84],"is":[85,201,227,249],"some":[86],"evidence":[87],"that":[88,150,216],"responded":[91],"fee":[93,178],"constraints":[94],"providing":[96],"additional":[97],"In":[99],"this":[100],"paper,":[101],"Janet":[102],"Mitchell":[103],"her":[105],"coauthors":[106],"track":[107],"trends":[108],"Medicare":[110,129],"spending":[112,157,182],"during":[113],"program's":[115],"recent":[116],"(1984-1986)":[117],"freeze":[118],"fees":[120],"doctors.":[125],"By":[126],"examining":[127],"claims":[130],"submitted":[131],"from":[134,198,246,265,288],"four":[135],"states":[136],"extrapolating":[138],"data":[140],"experience":[143],"states,":[146],"authors":[148],"found":[149],"program":[152],"its":[154,218],"beneficiaries":[155],"were":[156,184],"29.5":[158],"percent":[159],"($582":[161],"versus":[162],"$450)":[163],"1986":[168],"than":[169],"was":[170,309],"case":[172],"three":[173],"years":[174],"earlier;":[175],"despite":[176],"freeze.":[179],"The":[180,256],"major":[181],"increases":[183],"surgery":[186],"diagnostic":[188],"tests.":[189],"Mitchell,":[190],"holds":[192,241,283],"doctorate":[194,243,285],"social":[196],"welfare":[197],"Brandeis":[199],"University,":[200,248],"president":[202,250],"Center":[205,315],"Health":[207,223,252,272,317],"Economics":[208,224,253,318],"Research,":[209,225,254],"Boston-area":[211],"based":[212],"nonprofit":[213],"research":[214],"organization":[215],"(with":[217],"sister":[219],"organization,":[220],"for-profit":[222],"Inc.)":[226],"devoted":[228],"exclusively":[229],"study":[232],"public-sector":[234],"health":[235,299],"financing":[236],"issues,":[237],"jerry":[238],"Cromwell,":[239],"economics":[245,287],"Harvard":[247],"Inc.":[255],"two":[257],"organizations":[258],"derive":[259],"virtually":[260],"revenues":[264],"federal":[266,278],"grants":[267],"contracts":[269],"with":[270],"Care":[273],"Financing":[274],"Administration":[275],"other":[277],"entities.":[279],"Gerard":[280],"Wedig":[281],"also":[282],"Harvard.":[289],"Before":[290],"assuming":[291],"his":[292],"current":[293],"position":[294],"assistant":[296],"professor":[297],"care":[300],"systems":[301],"at":[302,313],"Wharton":[304],"School":[305],"Philadelphia,":[307],"he":[308],"senior":[311],"economist":[312],"Research.":[319]},"counts_by_year":[{"year":2016,"cited_by_count":1},{"year":2015,"cited_by_count":3},{"year":2014,"cited_by_count":1},{"year":2013,"cited_by_count":2}],"updated_date":"2026-10-31T12:09:11.096373","created_date":"2016-06-24T00:00:00"}
