The impact of the managed care backlash on health care spending

• 成果类型: Article
• 署名作者: Pinkovskiy, Maxim L.
• 署名单位: Federal Reserve System - USA; Federal Reserve Bank - New York
• 刊物名称: RAND JOURNAL OF ECONOMICS
• ISSN/ISSBN: 0741-6261
• DOI: 10.1111/1756-2171.12306
• 发表日期: 2020
• 页码: 59-108
• 关键词: technological-change; adverse selection; panel-data; insurance; cost; expenditures; restrictions; coverage; POLITICS; QUALITY

摘要

The health spending slowdown associated with the managed care revolution in the 1990s suggests that managed care may have been successful in controlling health care spending. I exploit the passage of state regulation during the managed care backlash as well as geographic variation in managed care intensity to measure the impact of managed care on spending. I find that restricting managed care causes a large and significant increase in hospital spending, which cannot be explained by changes in hospital market concentration, other regulatory activity, and multiple other possible explanations. I also do not find effects of the backlash on mortality.