Theses and Dissertations at Montana State University (MSU)
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Item Does direct primary care affect medicare opt-out rates? Evidence from state business of insurance legislation(Montana State University - Bozeman, College of Agriculture, 2022) Vogel, Trevor Jacob; Chairperson, Graduate Committee: Mariana CarreraPast economic research has examined factors influencing the degree to which physicians accept assignment from Medicare and allow new Medicare patients into their practice. There is no known examination of physicians' decision to opt out of Medicare completely. I study this decision in the context of Direct Primary Care, a growing alternative to fee-for-service healthcare delivery in the United States that has been enabled by state-level policy shielding DPC practitioners from insurance regulations. Using the publicly available National Provider Identifier Registry and Opt- Out Affidavit datasets in a difference-in-difference framework, I study the effect of said policy on the propensity of physicians to opt out of Medicare. In my main analysis, I estimate that treatment increases the likelihood of family physicians opting out by 38 - 46% of the panel's baseline opt-out rate, but find no consistent effect on internal medicine providers. This relationship is valuable for policymakers and healthcare providers to keep in mind in evaluating DPC and possible Medicare reform.Item A survey to determine the feasibility of purchasing health care insurance for Medicaid recipients(Montana State University - Bozeman, College of Business, 1993) Sherard, Robert Oral; Chairperson, Graduate Committee: Norman L. MillikinThe purpose of this study was to determine the feasibility of purchasing health care insurance for Medicaid recipients in Wyoming. Surveys were mailed to 218 employers throughout Wyoming, with 142 responding. Of the 142, 96 offered some form of group health insurance to their employees. The names of insurance carriers were taken from the 96 responses with insurance and a second survey was sent to the carriers. The number of responses was next to nil, with only 1 carrier expressing any interest in develping a program that would benefit all Medicaid recipients. From the data collected, and literature that was reviewed, the researcher determined that providing the portion of the eligible recipients (employees) group health program was not feasible. Instead, the researcher recommends that a task force be established to develop a comprehensive group health insurance program that would cover all eligible Medicaid recipients, small businesses, and family owned farms and ranches.