Strategic Formulary Design in Medicare Part D Plans

• 成果类型: Article
• 署名作者: Lavetti, Kurt; Simon, Kosali
• 署名单位: University System of Ohio; Ohio State University; Indiana University System; Indiana University Bloomington; National Bureau of Economic Research
• 刊物名称: AMERICAN ECONOMIC JOURNAL-ECONOMIC POLICY
• ISSN/ISSBN: 1945-7731
• DOI: 10.1257/pol.20160248
• 发表日期: 2018
• 页码: 154-192
• 关键词: insurance markets; benefit design; IMPACT; program; CHOICE; drugs

摘要

The design of Medicare Part D causes most beneficiaries to receive fragmented health insurance, with drug and medical coverage separated. Fragmentation is potentially inefficient since separate insurers optimize over only one component of healthcare spending, despite complementarities and substitutabilities between healthcare types. Fragmentation of only some plans can also lead to market distortions due to differential adverse selection, as integrated plans may use drug formularies to induce enrollment by patients that are profitable in the medical insurance market. We study the design of insurance plans in Medicare Part D and find that formularies reflect these two differences in incentives. (JEL D82,G22,H51,113,118,L65)