Health Care Rationing in Public Insurance Programs: Evidence from Medicaidt

被引：4
|
作者：
Layton, Timothy J. [1 ,2 ]
Maestas, Nicole [1 ,2 ]
Prinz, Daniel [3 ,4 ]
Vabson, Boris [1 ]
机构：
[1] Harvard Univ, Cambridge, MA 02138 USA
[2] NBER, Cambridge, MA 02138 USA
[3] World Bank, Cambridge, MA USA
[4] Inst Fiscal Studies, London, England
来源：
AMERICAN ECONOMIC JOURNAL-ECONOMIC POLICY | 2022年 / 14卷 / 04期
关键词：
QUALITY-OF-CARE; MANAGED CARE; COMPETITION;
D O I：
10.1257/pol.20190628
中图分类号：
F [经济];
学科分类号：
02 ;
摘要：
We study two mechanisms used by public health insurance programs for rationing health care: outsourcing to private managed care plans and quantity limits for prescription drugs. Leveraging a natural experiment in Texas's Medicaid program, we find that the shift to managed care and the relaxation of a strict drug cap increased access to high-value drugs and outpatient services and reduced avoidable hospitalizations. Program costs increased significantly, indicating a trade-off between cost and quality. We provide suggestive evidence attributing the reduction in hospitalizations to the relaxation of the drug cap and much of the spending increase to the shift to managed care. (JEL G22, H75, I13, I18, I38)
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页码：397 / 431
页数：35
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