Health Care Spending and Utilization in Public and Private Medicare

• 成果类型: Article
• 署名作者: Curto, Vilsa; Einav, Liran; Finkelstein, Amy; Levin, Jonathan; Bhattacharya, Jay
• 署名单位: Harvard University; Harvard T.H. Chan School of Public Health; Stanford University; National Bureau of Economic Research; Massachusetts Institute of Technology (MIT); Stanford University; Stanford University
• 刊物名称: AMERICAN ECONOMIC JOURNAL-APPLIED ECONOMICS
• ISSN/ISSBN: 1945-7782
• DOI: 10.1257/app.20170295
• 发表日期: 2019
• 页码: 302-332
• 关键词: regional-variations; CONSEQUENCES; services; hmos

摘要

We compare health care spending in public and private Medicare using newly available claims data from Medicare Advantage (MA) insurers. MA insurer revenues are 30 percent higher than their health care spending. Adjusting for enrollee mix, health care spending per enrollee in MA is 9 to 30 percent lower than in Traditional Medicare (TM), depending on the way we define comparable enrollees. Spending differences primarily reflect differences in health care utilization, with similar reductions for high-value and low-value care, rather than health care prices. We present evidence consistent with MA plans encouraging substitution to less expensive care and engaging in utilization management. (JEL G22, H44, H51, I11, I13)