Effects of Competition and Rate Regulation on Access to Physician Services and Uncompensated Care

This project extended a previous analysis of the impact of the New Jersey Uncompensated Care Trust Fund on access to and use of hospital services by the uninsured, and of the impact of reduced hospital financial status on the provision of uncompensated care in California. The New Jersey portion of the study examined whether observed differences in the type and quantity of services received by the uninsured were attributable to physician factors. Investigators examined whether: (1) uninsured patients receive care from different physicians than patients covered by Medicaid and private insurance; (2) patients from different payer groups are treated differently by the same physician; and (3) what role the individual physician plays in explaining differences in costs among similar patients from different payer groups. The California portion of the study assessed the effects of the recently-observed reduced financial status of hospitals associated with increased competition in the state on the provision of uncompensated care.