Sloan, Frank A., and Bruce Steinwald. 1978. "Physician Participation in Health Insurance Plans: Evidence on Blue Shield." Journal of Human Resources 13(2):237-263.

Various health insurance programs, including Blue Shield, have developed arrangements whereby the physician agrees to accept the insurer's reimbursement as payment in full. Incentives facing the physician to accept an arrangement of this type are reviewed in this study. The empirical work uses individual physicians from a 1973 survey. The results indicate that physician willingness to accept insurer reimbursement as payment in full is sensitive to the amount the insurer pays for specific procedures and to other insurance program characteristics. Physicians located in high patient income areas and/or with relatively prestigious credentials are less likely to accept insurer payments as payment in full. The empirical findings are used to generate policy implications pertaining to the Medicare and Medicaid programs, to medical care quality-access tradeoffs, and to national health insurance.

Sloan is Professor of Economics, Vanderbilt University. Steinwald is Project Manager, Vanderbilt University for Public Policy Studies. This research was supported by Grant HS-00825 from the Health Resources Administration, National Center for Health Services Research, U.S. Department of Health, Education, and Welfare, to the University of Florida. We are indebted to Robert Hansen for research assistance; to the National Association of Blue Shield Plans for its cooperation and assistance; and to Roger Feldman, Jack Hadley, staff members of the Center for Health Services Research and Development, American Medical Association, participants of the Health Economics Seminar at Harvard, and to an anonymous reviewer for comments on earlier drafts. All remaining errors are the responsibility of the authors. An earlier version of this paper was presented at the Western Economic Association meeting, San Diego, June 1975. At the time the paper was written, Professor Sloan was Associate Professor of Economics and Community Health and Family Medicine, University of Florida, and Mr. Steinwald was Research Associate, Center for Health Services Research and Development, American Medical Association.

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