As the U.S. population ages and health care costs continue to rise, policies aimed to control costs have become a major focus of the reform effort. Provider payment reform is at the core of these policies. The overall aim of this research is to understand the implications of provider payment reform on health care costs and physician behavior. The proposed research is largely empirical, but there is an economic theory component. This project will center on an empirical evaluation of a large payment reform policy in a private plan environment.
Cl aims and enrollment data will be used to study the effects of changing a physician group's reimbursement towards prospective payment on costs, utilization, and physician referral behavior. The project will also develop two simple economic models, a normative model of physician optimal referral and a positive model of physician specialization, to complement the empirical work.

Public Health Relevance

As provider payment reform is a central tool for controlling health care costs, understanding how payment reform affects the cost and quality of care is an important objective for policymakers and public health officials. The proposed project provides the public health and health policy communities a rigorous evidence-based evaluation of a large provider payment reform initiative.

National Institute of Health (NIH)
National Institute on Aging (NIA)
Individual Predoctoral NRSA for M.D./Ph.D. Fellowships (ADAMHA) (F30)
Project #
Application #
Study Section
Special Emphasis Panel (ZRG1-F16-B (20))
Program Officer
Bhattacharyya, Partha
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Harvard University
Schools of Medicine
United States
Zip Code
Donohue, Julie M; Barry, Colleen L; Stuart, Elizabeth A et al. (2018) Effects of Global Payment and Accountable Care on Medication Treatment for Alcohol and Opioid Use Disorders. J Addict Med 12:11-18
Song, Zirui; Rose, Sherri; Chernew, Michael E et al. (2017) Lower- Versus Higher-Income Populations In The Alternative Quality Contract: Improved Quality And Similar Spending. Health Aff (Millwood) 36:74-82
Stuart, Elizabeth A; Barry, Colleen L; Donohue, Julie M et al. (2017) Effects of accountable care and payment reform on substance use disorder treatment: evidence from the initial 3 years of the alternative quality contract. Addiction 112:124-133
Huskamp, Haiden A; Greenfield, Shelly F; Stuart, Elizabeth A et al. (2016) Effects of Global Payment and Accountable Care on Tobacco Cessation Service Use: An Observational Study. J Gen Intern Med 31:1134-40
Loehrer, Andrew P; Hawkins, Alexander T; Auchincloss, Hugh G et al. (2016) Impact of Expanded Insurance Coverage on Racial Disparities in Vascular Disease: Insights From Massachusetts. Ann Surg 263:705-11
Song, Zirui; Blumenthal, Daniel M (2016) Expanding Payment Reform in Medicare: The Cardiology Episode-Based Payment Model. JAMA 316:1973-1974
Loehrer, Andrew P; Song, Zirui; Haynes, Alex B et al. (2016) Impact of Health Insurance Expansion on the Treatment of Colorectal Cancer. J Clin Oncol 34:4110-4115
Song, Zirui; Colla, Carrie H (2016) Specialty-Based Global Payment: A New Phase in Payment Reform. JAMA 315:2271-2
Wallace, Jacob; Song, Zirui (2016) Traditional Medicare Versus Private Insurance: How Spending, Volume, And Price Change At Age Sixty-Five. Health Aff (Millwood) 35:864-72
Loehrer, Andrew P; Chang, David C; Hutter, Matthew M et al. (2015) Health Insurance Expansion and Treatment of Pancreatic Cancer: Does Increased Access Lead to Improved Care? J Am Coll Surg 221:1015-22

Showing the most recent 10 out of 41 publications