Identifying Experimental Program Effects with Confounding Price Changes and Selection Bias: The Municipal Health Services Program

The Municipal Health Services Program attempted to improve access to health care while containing costs by establishing primary care centers in underserved urban areas. The Health Care Financing Administration agreed to waive normal Medicare copayments for services delivered under the program. The establishment of primary care centers was successful in meeting its objectives. The waiver of copayments increased expenditures but not enough to fully offset savings from the reorganization of services.