32 terms

Midterm 2 Study Guide

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Akerlof
This author purports the lemon's example in adverse selection
Cutler
This author considers an "adverse selection death spiral" in NJ
Cutler and Zeckhauser
These two authors investigate HMO and PPO enrollment as good and bad health insurance plans to investigate the impacts of adverse selection
Zwanziger and Meirowitz
These two authors define plan contracts with hospitals in a study that looks at three categories.
Donabedian
This author considered the three factors related to hospital quality: structure, process and autcome
Luft
This author concluded that HMO enrollees had a lower hospitalization rate.
Arnould
This author concluded that the length of hospitalization stay did not differ significantly for HMO and FFS enrollees.
28
the RAND Health Insurance Experiment found that HMO annual plan spending was _ percent lower than FFS spending. They found good results because they were able to control for selection bias.
Miller and Luft
These two authors summarized findings on quality, utilization and customer satisfaction. They made several findings. (1) MCOs conducted more tests // procedures // exams. (2) Outcomes wee the same for HMO and FFS enrollees. (3) HMO enrollees were generally less satisfied with the quality of care. (4) HMO cut hospitalization and icnreased the use of testing
Cutler
This author found no differences in frequency of expensive procedures between HMO and FFS, all cost advantages from lower prices, no apparent quality trade-off.
Luft and Newhouse
These two authors found the growth rate of HMO spending, and found that growth rate to be the same as under FFS. HMOs were exposed to the same LR cost drivers as FFS services.
Marquis
This author investigated the HMO backlash. He found that even though there was limited switching between HMO plans or consumer exits from HMO markets, people were increasingly dissatisfied with HMOs.
Madrian
This author made the following conclusions. Workers with health insurance are more likely to switch jobs. They might settle for a job too soon in order to get health insurance when predicting need.
Gruber and Madrian, 65, 33, 10
These two authors studied COBRA, find out that _% of workers without an insurance source use COBRA, have an increased likelihood of retirement by _% and have a reduced job lock by _%
Garthwaite
This author considered employment lock by looking at cutbacks on Tennessee's Medicaid.
Melnick and Keller
These authors showed that hospitals which were members of multihospital systems increased their prices between 1999 much higher than non-members
Dafny
This author an instrumental variable approach to find the causal effect of mergers on prices. There is sizable, persistent positive effect.
Cutler and Scott-Morton
These two authors find that as concentration in hospitals has risen, inpatient days in hospitals and the number of acute care hospitals in the U.S> has gone down.
Ho
This author investigates the determinants of hospital market power. Shee finds that cardiac, imaging and cancer services are the most significant contributors to an increase in prices.
Cooper
This author comes to several findings. First, price variation is the main driver of spending variation. Prices vary routinely by a factor of 3 within HHR and 8 or more across the entire country. There is a low correlation between private and medicare spending, and prices are higher in monopoly or duopoly markets.
Cutler and Scott-Morton
These two authors consider HHRs and the C4 ratio -- the market share of the top four hospitals in a HHR. They find this rate to be 80%
Kessler and McClellan
These two authors considered the effects on hospital competition on the costs and outcomes for Medicare beneficiaries. Improved outcomes but raised costs. After 1990, this difference got better for consumers.
Zwanzinger and Mooney
These two authors considered HMOs in NY, which until 1996 regulated rates private insurers paid for inpatient cares. After deregulation, HMO s negotiated lower prices
Cooper and Gaynor
These two authors found that in England, more competition reduced mortality. Since there was no cost to patient, quality was the remaining dynamic of competition
Baiker, 1, 2.2
This author uses a longitudinal specification to understand the level of malpractice settlements on Medicare spending. Finds that 10% higher malpractice settlements lead to _% higher Medicare spending and _% more spending on imaging tests.
15.7, 20
Numbers from Cooper. He found that prices were _% higher for monopoly and duopoly markets compared to the rest. They also found that _% of price variations are within hospitals.
Changes
Baiker deals for time invariant factors by comparing _ in malpractice spending with _ in prices. (same word for both!)
Roemer
This author studied hospital utilization in reaction to capacity expansion. Physicians create their own demand, because they diagnose in their treat. IF they settle wherever, they would increase prices to hit their personal goals.
Fuchs
This author proposed limiting the number of doctors to limit the inducement of demand. Issues were raised becuase of the study's identification.
Dranove and Wehner
This paper uses the same methodology as Fuchs to understand the inducement of childbirths.
Gruber and Owings
These two authors use differential decrease in fertility across US states as identifying variation. Find significant but not large inducement. Fertility down, but C sections have gone up and 1/3 of increase in C sections are due to physicians raising more money.
Gawande
This author -- in a NJ city, small amount of patients that charge a lot. the solution was to coordinate out of hospital care to reduce ER visits and to make sure that people take their medication in order to reduce high cost treatment.