NATIONAL BUREAU OF ECONOMIC RESEARCH
NATIONAL BUREAU OF ECONOMIC RESEARCH

Eli Liebman

Bureau of Economic Analysis

E-Mail: EmailAddress: hidden: you can email any NBER-related person as first underscore last at nber dot org

NBER Working Papers and Publications

December 2016Attribution of Health Care Costs to Diseases: Does the Method Matter?
with Allison B. Rosen, Ana Aizcorbe, Tina Highfill, Michael E. Chernew, Kaushik Ghosh, David M. Cutler
in Measuring and Modeling Health Care Costs, Ana Aizcorbe, Colin Baker, Ernst Berndt, and David Cutler, editors
Cost of illness (COI) studies focus on allocating health expenditures to a comprehensive set of diseases. A variety of techniques have been used to allocate spending to diseases. In this paper, we compare spending attributed to diseases using three approaches: one based on the principal diagnosis listed on each encounter’s claim, a second based on all diagnoses listed on the encounter, and a third based on decomposing a person’s total annual spending to their conditions. The study sample is large: 2.3 million commercially insured individuals under age 65. Results indicate significant differences in the allocations from the different approaches. The two claims-based encounter approaches allocate 78% of overall spending to diseases, while the person approach allocates 95% of spending to d...
October 2016Decomposing Medical-Care Expenditure Growth
with Abe Dunn, Adam Hale Shapiro
in Measuring and Modeling Health Care Costs, Ana Aizcorbe, Colin Baker, Ernst Berndt, and David Cutler, editors
Medical-care expenditures have been rising rapidly, accounting for over 17 percent of GDP in 2012. In this study, we assess the sources of the rising medical-care expenditures in the commercial sector. We employ a novel framework for decomposing expenditure growth into four components at the disease level: service price growth, service utilization growth, treated disease prevalence growth, and demographic shift. The decomposition shows that growth in prices and treated prevalence are the primary drivers of medical-care expenditure growth over the 2003 to 2007 period. There was no growth in service utilization at the aggregate level over this period. Price and utilization growth were especially large for the treatment of malignant neoplasms. For many conditions, treated prevalence has shift...
September 2014Developing a Framework for Decomposing Medical-Care Expenditure Growth: Exploring Issues of Representativeness
with Abe Dunn, Adam Hale Shapiro
in Measuring Economic Sustainability and Progress, Dale W. Jorgenson, J. Steven Landefeld, and Paul Schreyer, editors
Medical care expenditures have been rising rapidly over time and in 2009 health care accounted for 17.9 percent of GDP, but there are many areas where we have an incomplete understanding of spending growth in this sector. This is especially true of the commercial sector, where our primary data sources are often non-random convenience samples (i.e., available claims data from contributing insurers and employers). The goal of this paper is to better understand issues related to using convenience samples to obtain nationally representative estimates of the various components of expenditure growth. Using a multitude of weighting strategies, including weighted and unweighted estimates, we find similar qualitative results with higher prevalence and increases in medical care service prices being ...
 
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