Getting the Price Right? The Impact of Competitive Bidding in the Medicare Program

• 成果类型: Article
• 署名作者: Ding, Hui; Duggan, Mark; Starc, Amanda
• 署名单位: Fudan University; Stanford University; National Bureau of Economic Research; Northwestern University
• 刊物名称: REVIEW OF ECONOMICS AND STATISTICS
• ISSN/ISSBN: 0034-6535
• DOI: 10.1162/rest_a_01249
• 发表日期: 2025-01
• 页码: 204-220
• 关键词: obstructive sleep-apnea; positive airway pressure; health-care; part d; procurement; therapy; auction

摘要

We study Medicare's competitive bidding program for durable medical equipment. We use Medicare claims data to examine the effect on prices and utilization, focusing on continuous positive airway pressure devices for sleep apnea. We find that spending falls by 47.2% after a highly imperfect bidding mechanism is introduced. This is almost entirely driven by a 44.8% price reduction, though quantities also fall by 4.3%. To disentangle supply and demand, we leverage differential cost sharing across Medicare recipients. We measure a demand elasticity of -0.272 and find that quantity reductions are concentrated among less clinically appropriate groups.