What Does a Provider Network Do? Evidence from Random Assignment in Medicaid Managed Care†

• 成果类型: Article
• 署名作者: Wallace, Jacob
• 署名单位: Yale University
• 刊物名称: AMERICAN ECONOMIC JOURNAL-ECONOMIC POLICY
• ISSN/ISSBN: 1945-7731
• DOI: 10.1257/pol.20210162
• 发表日期: 2023
• 页码: 473-509
• 关键词: health-insurance; information frictions; hospital prices; part d; CHOICE; COMPETITION; state; pay

摘要

Leveraging the random assignment of over 50,000 Medicaid enroll-ees in New York, I present causal evidence that narrower networks are a blunt instrument for reducing health care spending. While nar-rower networks constrain spending, they do so by generating hassle costs that reduce quantity, with modest effects on prices paid to pro-viders. Enrollees assigned to narrower networks use fewer of both needed and unneeded services and are less satisfied with their plans. Using my causal estimates to construct counterfactuals, I identify an alternative assignment policy that reduces spending without harm-ing satisfaction by matching consumers with narrower networks that include their providers. (JEL H51, H75, I13, I18, I38)