Health and Medical Care Archive

This study is maintained and distributed by the Health and Medical Care Archive (HMCA). HMCA is the official data archive of the Robert Wood Johnson Foundation.

Physician Responses to Medicare Payment Reductions: Impacts on the Public and Private Sectors, 1988-1991 (ICPSR 6563)

Principal Investigator(s): Rice, Thomas, University of California-Los Angeles; Stearns, Sally, University of North Carolina


The purpose of this study was to investigate the effects on physician behavior of decreases in Medicare payment rates for surgical procedures. The study examined the volume of services provided, billed charges, and the selection of diagnostic or therapeutic alternative procedures, or clinically unrelated procedures, for Medicare and privately-insured patients. Also studied were the proportion of physician income derived from Medicare and the profitability of procedures as they related to the volume of services provided. This data collection comprises observations for 21 surgical procedure groups in the specialty areas of general surgery, gastroenterology, orthopedic surgery, ophthalmology, urology, gynecological surgery, thoracic surgery, and cardiology, from up to 187 hospitals and for up to 15 quarters. Efforts were made to include high volume and expensive procedures. Excluded were radiology, pathology, or other lab procedures, and procedures that had experienced erratic changes in volume due to changes in technology or changes in national standards. Also included in this collection are hospital characteristics and county-level data pertaining to number of hospital beds, per capita income, licensed practical nurse and registered nurse wages, doctors per 1000 population, and health maintenance organization enrollees per 1000 population.

Access Notes

  • The public-use data files in this collection are available for access by the general public. Access does not require affiliation with an ICPSR member institution.


DS1:  Raw Data - Download All Files (18.262 MB)
DS2:  Data in SAS Transport Format - Download All Files (13.999 MB)

Study Description


Rice, Thomas, and Sally Stearns. Physician Responses to Medicare Payment Reductions: Impacts on the Public and Private Sectors, 1988-1991. ICPSR06563-v1. Ann Arbor, MI: Inter-university Consortium for Political and Social Research [distributor], 1998.

Persistent URL:

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This study was funded by:

  • Robert Wood Johnson Foundation (20038)

Scope of Study

Subject Terms:    hospitals, medical care, medical procedures, Medicare, older adults

Geographic Coverage:    United States

Time Period:   

  • 1988-04--1991-12

Universe:    All United States hospitals.

Data Type(s):    survey data, event/transaction data, and administrative records data

Data Collection Notes:

(1) The SAS transport file (Part 2) was written using the SAS XPORT engine.


Sample:    Convenience sample representing 3.7 percent of the universe.

Data Source:

(1) Hospital abstracts: Commission on Professional and Hospital Activities, Ann Arbor, MI, (2) Medicare price data: Part B Medicare Annual Data Files provided by Physician Payment Review Commission, (3) Private price data: MEDSTAT, Inc., Ann Arbor, MI, (4) Hospital characteristics: American Hospital Association, Chicago, IL, Annual Survey of Hospitals, and (5) Area characteristics: Area Resource File, Current Population Survey


Original ICPSR Release:   1995-12-20

Version History:

  • 1998-04-28 The codebook is now available as a PDF file.

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