The Spillover Effects of Medicare Managed Care: Medicare Advantage and Hospital Utilization

Katherine Baicker, Michael Chernew, Jacob Robbins

NBER Working Paper No. 19070
Issued in May 2013
NBER Program(s):Economics of Aging, Health Care

More than a quarter of Medicare beneficiaries are enrolled in Medicare Advantage, which was created in large part to improve the efficiency of health care delivery by promoting competition among private managed care plans. This paper explores the spillover effects of the Medicare Advantage program on the traditional Medicare program and other patients, taking advantage of changes in Medicare Advantage payment policy to isolate exogenous increases in Medicare Advantage enrollment and trace out the effects of greater managed care penetration on hospital utilization and spending throughout the health care system. We find that when more seniors enroll in Medicare managed care, hospital costs decline for all seniors and for commercially insured younger populations. Greater managed care penetration is not associated with fewer hospitalizations, but is associated with lower costs and shorter stays per hospitalization. These spillovers are substantial - offsetting more than 10% of increased payments to Medicare Advantage plans.

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Document Object Identifier (DOI): 10.3386/w19070

Published: Journal of Health Economics Volume 32, Issue 6, December 2013, Pages 1289–1300 Cover image The spillover effects of Medicare managed care: Medicare Advantage and hospital utilization Katherine Baickera, , , Michael E. Chernewb, Jacob A. Robbinsc citation courtesy of

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