NBER Working Papers by Jason Abaluck

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Working Papers

March 2014Negative Tests and the Efficiency of Medical Care: What Determines Heterogeneity in Imaging Behavior?
with Leila Agha, Christopher Kabrhel, Ali Raja, Arjun Venkatesh: w19956
We develop a model of the efficiency of medical testing based on the frequency of negative CT scans for pulmonary embolism. The model is estimated using a 20% sample of Medicare claims from 2000-2009. We document enormous heterogeneity in testing conditional on patient population. Less experienced physicians and those practicing in high spending areas test more low-risk patients. Assessing the efficiency of current practices requires calibration assumptions regarding the costs of testing, the benefits of treatment and the likelihood of false positives. While we cannot tell whether any particular testing decision was mistaken in the context of our model, we find that collectively–given these additional calibration assumptions–there are systematic differences between doctor testing practices...
June 2013Evolving Choice Inconsistencies in Choice of Prescription Drug Insurance
with Jonathan Gruber: w19163
We explore choice inconsistency over time within the Medicare Part D Prescription Drug Program. Using the full universe of Part D claims data, we revisit our earlier work on partial data to replicate our results showing large “foregone savings” among Part D enrollees. We also document that this foregone savings increases over time during the first four years of the Part D program. We then develop a rich dynamic structural framework that allows us to mathematically decompose the “foregone welfare” from inconsistent plan choices into components due to demand side factors, supply side factors, and changes in preferences over time. We find that the welfare cost of choice inconsistencies increases over time. Most importantly, we find that there is little improvement in the ability of consum...
February 2009Choice Inconsistencies Among the Elderly: Evidence from Plan Choice in the Medicare Part D Program
with Jonathan Gruber: w14759
The Medicare Part D Prescription Drug Plan represents the most significant privatization of the delivery of a public insurance benefit in recent history, with dozens of private insurers offering a wide range of products with varying prices and product features; the typical elder had a choice of roughly 40 stand-alone drug plans. In this paper we evaluate the choices of elders across this wide array of Part D options using a unique data set of prescription drug claims matched to information on the characteristics of choice sets. We first document that the vast majority of elders are choosing plans that are not on the "efficient portfolio" of plan choice in the sense that an alternative plan offers better risk protection at a lower cost. We then estimate several discrete choice models to ...

Published: Abaluck, Jason, and Jonathan Gruber. 2011. "Choice Inconsistencies among the Elderly: Evidence from Plan Choice in the Medicare Part D Program." American Economic Review, 101(4): 1180-1210.

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