Jim Reschovsky, Ph.D.
Jim Reschovsky, Ph.D., is a senior fellow at the Center for Studying Health System Change (HSC). Prior to joining HSC in 1996, he served as a research fellow with the Agency for Health Care Research and Quality (AHRQ) and held faculty positions at Cornell and Michigan State Universities. Dr. Reschovsky’s research interests include health care delivery system issues, particularly provider payment policies and the impact of provider financial and other incentives on treatment patterns and costs. His work has been published in numerous journals, including International Journal of Health Care Finance and Economics, Health Affairs, Health Services Research, Journal of the American Medical Association, and New England Journal of Medicine.
Dr. Reschovsky received master’s and doctorate degrees from the University of Michigan in Public Policy and a bachelor’s degree in Government from Franklin & Marshall College.
Since 2007, Dr. Reschovsky has conducted two HCFO-funded studies. From 2007 to 2009, he served as co-primary investigator (PI) with Jack Hadley of George Mason University on a study that examined how physicians’ provision of specific medical services to Medicare FFS beneficiaries responds to variations in Medicare physician fees for those services, physicians’ characteristics, and to local market factors. Results of this study, published in the Winter 2009/2010 issue of Inquiry, found that Medicare fees are positively related to quantity provided for eight specifically examined services. These results imply that Medicare could influence volume growth for specific services by varying their fees. From 2008 to 2011, Dr. Reschovsky served as the PI on a grant that examined key physician practice and market characteristics that may contribute to high costs and inefficient care in the Medicare program. Results of this study, published in the July 2011 issue of Health Services Research, found that among high-costs beneficiaries, health was the predominant predictor of costs, with most physician and practice and many market factors (including provider supply) insignificant or weakly related to cost. Beneficiaries whose usual physician was a medical specialist or reported inadequate office visit time, medical specialist supply, provider for-profit status, care fragmentations, and Medicare fees were associated with higher costs.1 Other results, published in the International Journal of Health Care Finance and Economics, indicate that even among high-cost Medicare beneficiaries—those most likely to be “at the flat of the curve” in terms of the effects of medical interventions, additional medical services result in significantly better medical outcomes. Finally, the study evaluated methods for adjusting for health status in geographic variation analyses of the Medicare population. Methods used in previous studies were found to be flawed and the study concludes that health differences account for much more of geographic cost variation than found in prior studies.
1. Hadley J et al. Medicare Fees and the Volume of Physicians' Services. Inquiry; Winter 2009/2010: 46 (4): pp. 372-390.