What Difference Does a Health Plan Make? Evidence from Random Plan Assignment in Medicaid /

Exploiting the random assignment of Medicaid beneficiaries to managed care plans, we find substantial plan-specific spending effects despite plans having identical cost sharing. Enrollment in the lowest-spending plan generates 30% lower spending--driven by differences in quantity--relative to enroll...

Ausführliche Beschreibung

Gespeichert in:
1. Verfasser:
Geruso, Michael
Körperschaft:
National Bureau of Economic Research
Weitere Verfasser:
Layton, Timothy J., Wallace, Jacob
Format:
Elektronisch E-Book
Sprache:
Englisch
Veröffentlicht:
Cambridge, Mass. National Bureau of Economic Research 2020.
Zusammenfassung:
Exploiting the random assignment of Medicaid beneficiaries to managed care plans, we find substantial plan-specific spending effects despite plans having identical cost sharing. Enrollment in the lowest-spending plan generates 30% lower spending--driven by differences in quantity--relative to enrollment in the highest-spending plan. Rather than reducing "wasteful" spending, lower-spending plans broadly reduce medical service provision--including the provision of low-cost, high-value care--and worsen beneficiary satisfaction and health. Consumer demand follows spending: a 10 percent increase in plan-specific spending is associated with a 40 percent increase in market share. These facts have implications for the government's contracting problem and program cost growth.
Umfang:
1 online resource: illustrations (black and white);
Anmerkungen:
August 2020.
Schlagworte: