NATIONAL BUREAU OF ECONOMIC RESEARCH
NATIONAL BUREAU OF ECONOMIC RESEARCH
loading...

The Impact of Increased Cost-sharing on Utilization of Low Value Services: Evidence from the State of Oregon

Jonathan Gruber, Johanna Catherine Maclean, Bill J. Wright, Eric S. Wilkinson, Kevin Volpp

NBER Working Paper No. 22875
Issued in December 2016
NBER Program(s):The Health Care Program, The Health Economics Program

In this study we examine the impact of a value-based insurance design (V-BID) program implemented between 2010 and 2013 at a large public employer in the state of Oregon. The program substantially increased cost-sharing, specifically copayments and coinsurance, for several healthcare services believed to be of low value and overused (sleep studies, endoscopies, advanced imaging, and surgeries). Using a differences-in-differences design coupled with granular, administrative health insurance claims data, we estimate the change in low value healthcare service utilization among beneficiaries before and after program implementation relative to a comparison group of beneficiaries who were not exposed to the V-BID. Our findings suggest that the V-BID significantly reduced utilization of targeted services. These findings have important implications for both public and private healthcare policies as V-BID principles are rapidly proliferating in healthcare markets.

download in pdf format
   (411 K)

email paper

Machine-readable bibliographic record - MARC, RIS, BibTeX

Document Object Identifier (DOI): 10.3386/w22875

Users who downloaded this paper also downloaded* these:
Brot-Goldberg, Chandra, Handel, and Kolstad w21632 What Does a Deductible Do? The Impact of Cost-Sharing on Health Care Prices, Quantities, and Spending Dynamics
Goodman-Bacon w22899 The Long-Run Effects of Childhood Insurance Coverage: Medicaid Implementation, Adult Health, and Labor Market Outcomes
Doyle, Graves, and Gruber w23166 Evaluating Measures of Hospital Quality
Chandra, Gruber, and McKnight w18023 The Impact of Patient Cost-Sharing on the Poor: Evidence from Massachusetts
GutiƩrrez and Philippon w22897 Investment-less Growth: An Empirical Investigation
 
Publications
Activities
Meetings
NBER Videos
Themes
Data
People
About

National Bureau of Economic Research, 1050 Massachusetts Ave., Cambridge, MA 02138; 617-868-3900; email: info@nber.org

Contact Us