# Health Policies, Physician Incentives, and Service Utilization for Non-Acute Diseases in Taiwan: The Case of Cataracts

## TL;DR

This study examines how different payment policies in Taiwan's healthcare system affect cataract treatment and outpatient services over 16 years.

## Contribution

The study provides new insights into how cost-containment policies influence healthcare utilization for non-acute diseases like cataracts.

## Key findings

- Global budgeting reduces the likelihood of cataract surgery and outpatient visits.
- Cost sharing significantly impacts outpatient service volume but not procedure adoption.
- Prospective payment schemes show no long-term effects on cataract treatment rates.

## Abstract

Background: Existing research highlights the necessity of tailoring cost-containment policies to specific treatments due to the varying benefits across different diseases. This study contributes additional insights by examining the impact of such policies on a non-acute condition—cataracts. Methods: Leveraging 16 years of national health insurance claim data, this research assesses the influence of three prevalent cost-containment payment schemes on healthcare service utilization. Outcome variables for analysis include the decision to adopt intraocular lens (IOL) insertion, outpatient visit volume, and healthcare expenditures. The robustness of the findings is enhanced through the use of statistical methods, such as logit, Poisson, negative binomial, and panel fixed-effect models. Results: Global budgeting reduces the likelihood of procedure adoption and negatively impacts the volume of outpatient consultation services. Cost sharing does not affect procedure adoption but significantly impacts outpatient service volume. The prospective payment scheme for cataract IOL treatment shows no long-term effects on service utilization, with treatment rates stabilizing after a few years of policy implementation. Despite reimbursement points remaining unchanged for over two decades, there is no evidence of the under-provision of treatment. Conclusions: This study underscores the significant responsiveness of both patients and providers to policy reforms in the non-acute disease category. Manipulating payment schemes can lead to cost savings, particularly when treatment plans and procedures exhibit increased elasticity in their provision.