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Financial Pressures Spur Physician Entrepreneurialism

March/April 2004
Health Affairs, Vol. 23, No. 2
Hoangmai H. Pham, Kelly Devers, Jessica H. May, Robert A. Berenson

Using data from Round Four of the Community Tracking Study (CTS) site visits, this paper describes how recent revenue and cost pressures have led physicians to aggressively increase prices and service volume and provide fewer traditional services that are less lucrative. As a result, physicians’ business practices are contributing to rising service use and hindering cost containment, which could impair access to critical services for certain populations. In response, policymakers may need to revisit regulation of physicians’ conflicts of interest and consider how their financial incentives could be realigned. But the diversity of physicians’ behavior requires that policy responses take account of differences between specialists and primary care physicians.

Free access to this article is available at the Health Affairs Web site.


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The Center for Studying Health System Change Ceased operation on Dec. 31, 2013.