The effect of HMOs on fee-for-service health care expenditures: Evidence from medicare revisited

Journal of Health Economics

Volumn 23, Issue 5, 2004, Pages 951-963

  Batata, Amber ^a  

^a UNIVERSITY OF CAMBRIDGE   (United Kingdom)

Author keywords

Fee for service; HMO; I11; Medicare; Selection

Indexed keywords

HEALTH CARE;

ARTICLE; COST BENEFIT ANALYSIS; HEALTH CARE COST; HEALTH MAINTENANCE ORGANIZATION; HEALTH SERVICE; HOSPITAL PATIENT; MATHEMATICAL COMPUTING; MEDICARE; OUTPATIENT;

AGED; CATCHMENT AREA (HEALTH); CROSS-SECTIONAL STUDIES; ECONOMIC COMPETITION; FEE-FOR-SERVICE PLANS; HEALTH CARE SECTOR; HEALTH EXPENDITURES; HEALTH MAINTENANCE ORGANIZATIONS; HEALTH SERVICES RESEARCH; HEALTH STATUS; HUMANS; MEDICARE; MODELS, ECONOMETRIC; REGRESSION ANALYSIS; UNITED STATES;

EID: 4444250785     PISSN: 01676296     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.jhealeco.2004.02.004     Document Type: Article

References (35)

1. Akerlof G. The market for 'Lemons': quality uncertainty and the market mechanism. Quarterly Journal of Economics. 84:1970;488-500
2. Arrow K. Uncertainty and the welfare economics of medical care. American Economic Review. 53(5):1963;941-973
3. Baker L. The effect of HMOs on fee-for-service health care expenditures: evidence from medicare. Journal of Health Economics. 16:1997;453-481
4. Baker L. Association of managed care market share and health expenditures for fee-for-service medicare patients. Journal of the American Medical Association. 281(5):1999;432-437
5. Baker L., Shankarkumar S. Managed care and health care expenditures: evidence from medicare, 1990-1994. Frontiers in Health Policy Research. 1:1998;117-151
6. Berndt, E.R., 1991. The Practice of Econometrics: Classic and Contemporary, Addison-Wesley Publishing Co.
7. Bertrand, M., Duflo, E., Mullainathan, S., 2004. How much should we trust differences-in-differences estimates? Quarterly Journal of Economics 119 (1).
8. Brown R.S., Clement D.G., Hill J.W., Retchin S.M., Bergeron J.W. Do health maintenance organizations work for medicare? Health Care Financing Review. 15(1):1993;7-23
9. Beeuwekes Buntin, M., 2003. Risk selection and product differentiation among Medicare HMOs. RAND Health. Unpublished manuscript.
10. Cao, Z., 2003. Comparing pre-HMO enrollment costs between stayers and switchers: medicare evidence of service-level selection, Mimeo. Cambridge Health Alliance.
11. Cao Z., McGuire T.G. Service-level selection by HMOs in medicare. Journal of Health Economics. 22(6):2003;915-931
12. Cutler D., Reber S. Paying for health insurance: the tradeoff between competition and adverse selection. Quarterly Journal of Economics. 113(2):1998;433-466
13. Ellis R. The effect of prior-year health expenditures on health coverage plan choice. Advances in Health Economics and Health Services Research. 6:1985;149-170
14. Ellis R. Creaming, skimping and dumping: provider competition on the intensive and extensive margins. Journal of Health Economics. 17:1998;537-555
15. Ellis R., McGuire T. Setting capitation payments in markets for health services. Health Care Financing Review. 8(4):1987;55-64
16. Feldman R., Dowd B. Simulation of a health insurance market with adverse selection. Operations Research. 30(6):1982;1027-1042
17. Feldman R., Dowd B. Risk segmentation: goal or problem? Journal of Health Economics. 19:2000;499-512
18. Frank R.G., Glazer J., McGuire T.G. Measuring adverse selection in managed health care. Journal of Health Economics. 19:2000;829-854
19. Glazer J., McGuire T. Optimal risk adjustment in markets with adverse selection: an application to managed care. American Economic Review. 90(4):2000;1055-1071
20. Gruber J., Levine P., Staiger D. Abortion legalization and child living circumstances: who is the marginal child? Quarterly Journal of Economics. 114(1):1999;263-291
21. Hellinger F.J. Selection bias in HMOs and PPOs: a review of the evidence. Inquiry. 32:1995;135-142
22. Hill, J., Brown, R., 1990. Biased Selection in the TEFRA HMO/CMP Program: Final Report. Mathematica Policy Research, Inc.
23. Hill, J., Brown, R., Chu, D., Bergeron, J., 1992. The Impact of the Medicare Risk Program on the Use of Services and Costs to Medicare: Final Version. Mathematica Policy Research, Inc.
24. Lamers L. Health-based risk adjustment: is inpatient and outpatient diagnostic information sufficient? Inquiry. 38:2001/2002;423-431
25. Langwell K., Hadley J. Evaluation of the medicare competition demonstrations. Health Care Financing Review. 11(2):1989;65-80
26. Luft, H., 1994. HMOs and the Elderly. Health Administration Press, Ann Arbor, MI.
27. Miller R.H., Luft H.S. Managed care plan performance since 1980: a literature analysis. Journal of the American Medical Association. 271(19):1994;1512-1519
28. Newhouse J. Rate-adjustor for medicare under capitation. Health Care Financing Review Annual Supplement. 7(Suppl.):1986;45-55
29. Newhouse J. Reimbursing health plans and health providers: efficiency in production versus selection. Journal of Economic Literature. 34:1996;1236-1263
30. Newhouse J. Risk adjustment: where are we now? Inquiry. 35:1998;122-131
31. Physician Payment Review Commission, 1996. Annual Report to Congress 1996. Physician Payment Review Commission, Washington, DC.
32. Ramsey S., Pauly M. Structural incentives and adoption of medical technologies in HMO and fee-for-service health insurance plans. Inquiry. 34:1997;228-236
33. Rossiter L.F., Langwell K.M., Brown R., Adamache K.W., Nelson L. Medicare expanded choice program: issues and evidence from the HMO experience. Advances in Health Economics and Health Services Research. 10:1989;3-40
34. Rothschild M., Stiglitz J. Equilibrium in competitive insurance markets: an essay on the economics of imperfect information. Quarterly Journal of Economics. 90(4):1976;629-649
35. Van de Ven, W.P.M.M., Ellis, R.P., 2000. Risk adjustment in competitive health plan markets. In: Culyer, R.J., Newhouse, J.P. (Eds.), Handbook of Health Economics. Elsevier Science, Amsterdam.