The Consequences of Health Care Privatization: Evidence from Medicare Advantage Exits
There is considerable controversy over the use of private insurers to deliver public health insurance benefits. We investigate the consequences of patients enrolling in Medicare Advantage (MA), privately managed care organizations that compete with the traditional fee-for-service Medicare program. W...
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| Format: | Article |
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American Economic Association
2018
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| Online Access: | http://hdl.handle.net/1721.1/114042 https://orcid.org/0000-0002-9877-3065 |
| _version_ | 1826197595225063424 |
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| author | Duggan, Mark Vabson, Boris Gruber, Jonathan |
| author2 | Massachusetts Institute of Technology. Department of Economics |
| author_facet | Massachusetts Institute of Technology. Department of Economics Duggan, Mark Vabson, Boris Gruber, Jonathan |
| author_sort | Duggan, Mark |
| collection | MIT |
| description | There is considerable controversy over the use of private insurers to deliver public health insurance benefits. We investigate the consequences of patients enrolling in Medicare Advantage (MA), privately managed care organizations that compete with the traditional fee-for-service Medicare program. We use exogenous shocks to MA enrollment arising from plan exits from New York counties in the early 2000s and utilize unique data that links hospital inpatient utilization to Medicare enrollment records. We find that individuals who were forced out of MA plans due to plan exit saw very large increases in hospital utilization. These increases appear to arise through plans both limiting access to nearby hospitals and reducing elective admissions, yet they are not associated with any measurable reduction in hospital quality or patient mortality. |
| first_indexed | 2024-09-23T10:50:01Z |
| format | Article |
| id | mit-1721.1/114042 |
| institution | Massachusetts Institute of Technology |
| last_indexed | 2024-09-23T10:50:01Z |
| publishDate | 2018 |
| publisher | American Economic Association |
| record_format | dspace |
| spelling | mit-1721.1/1140422022-09-27T15:22:34Z The Consequences of Health Care Privatization: Evidence from Medicare Advantage Exits Duggan, Mark Vabson, Boris Gruber, Jonathan Massachusetts Institute of Technology. Department of Economics Gruber, Jonathan There is considerable controversy over the use of private insurers to deliver public health insurance benefits. We investigate the consequences of patients enrolling in Medicare Advantage (MA), privately managed care organizations that compete with the traditional fee-for-service Medicare program. We use exogenous shocks to MA enrollment arising from plan exits from New York counties in the early 2000s and utilize unique data that links hospital inpatient utilization to Medicare enrollment records. We find that individuals who were forced out of MA plans due to plan exit saw very large increases in hospital utilization. These increases appear to arise through plans both limiting access to nearby hospitals and reducing elective admissions, yet they are not associated with any measurable reduction in hospital quality or patient mortality. 2018-03-09T20:29:07Z 2018-03-09T20:29:07Z 2018-02 2018-02-22T18:05:21Z Article http://purl.org/eprint/type/JournalArticle 1945-7731 1945-774X http://hdl.handle.net/1721.1/114042 Duggan, Mark, Jonathan Gruber, and Boris Vabson. “The Consequences of Health Care Privatization: Evidence from Medicare Advantage Exits.” American Economic Journal: Economic Policy 10, no. 1 (February 2018): 153–186. © 2018 American Economic Association https://orcid.org/0000-0002-9877-3065 http://dx.doi.org/10.1257/pol.20160068 American Economic Journal: Economic Policy Article is made available in accordance with the publisher's policy and may be subject to US copyright law. Please refer to the publisher's site for terms of use. application/pdf American Economic Association American Economic Association |
| spellingShingle | Duggan, Mark Vabson, Boris Gruber, Jonathan The Consequences of Health Care Privatization: Evidence from Medicare Advantage Exits |
| title | The Consequences of Health Care Privatization: Evidence from Medicare Advantage Exits |
| title_full | The Consequences of Health Care Privatization: Evidence from Medicare Advantage Exits |
| title_fullStr | The Consequences of Health Care Privatization: Evidence from Medicare Advantage Exits |
| title_full_unstemmed | The Consequences of Health Care Privatization: Evidence from Medicare Advantage Exits |
| title_short | The Consequences of Health Care Privatization: Evidence from Medicare Advantage Exits |
| title_sort | consequences of health care privatization evidence from medicare advantage exits |
| url | http://hdl.handle.net/1721.1/114042 https://orcid.org/0000-0002-9877-3065 |
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