Physician responses to insurance benefit restrictions: The case of ophthalmology

Abstract

AbstractThis study examines the impact of social insurance benefit restrictions on physician behaviour, using ophthalmologists as a case study. We examine whether ophthalmologists use their market power to alter their fees and rebates across services to compensate for potential policy‐induced income losses. The results show that ophthalmologists substantially reduced their fees and rebates for services directly targeted by the benefit restriction compared to other medical specialists' fees and rebates. There is also some evidence that they increased their fees for services that were not targeted. High‐fee charging ophthalmologists exhibited larger fee and rebate responses while the low‐fee charging group raise their rebates to match the reference price provided by the policy environment.