15 results match your criteria American Economic Journal-economic Policy[Journal]

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Strategic Formulary Design in Medicare Part D Plans.

Am Econ J Econ Policy 2018 Aug;10(3):154-192

Indiana University and NBER, School of Public and Environmental Affairs, 1315 E 10th St, Bloomington, IN.

The design of Medicare Part D causes most beneficiaries to receive fragmented health insurance, with drug and medical coverage separated. Fragmentation is potentially inefficient since separate insurers optimize over only one component of healthcare spending, despite complementarities and substitutabilities between healthcare types. Fragmentation of only some plans can also lead to market distortions due to differential adverse selection, as integrated plans may use drug formularies to induce enrollment by patients that are profitable in the medical insurance market. Read More

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http://dx.doi.org/10.1257/pol.20160248DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6335045PMC
August 2018
1 Read

Private provision of social insurance: drug-specific price elasticities and cost sharing in Medicare Part D.

Am Econ J Econ Policy 2018 Aug;10(3):122-153

Department of Health Research and Policy, Stanford University, and NBER, Redwood Building T111, 150 Governor's Lane, Stanford, CA 94305.

We explore how private drug plans set cost-sharing in the context of Medicare Part D. While publicly-provided drug coverage typically involves uniform cost-sharing across drugs, we document substantial heterogeneity in the cost-sharing for different drugs within privately-provided plans. We also document that private plans systematically set higher consumer cost sharing for drugs or classes associated with more elastic demand; to do so we estimate price elasticities of demand across more than 150 drugs and across more than 100 therapeutic classes. Read More

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http://dx.doi.org/10.1257/pol.20160355DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6141206PMC
August 2018
1 Read

Causal Spousal Health Spillover Effects and Implications for Program Evaluation.

Am Econ J Econ Policy 2017 Nov;9(4):144-166

Current methods of cost effectiveness analysis implicitly assume zero spillovers among social ties. This can underestimate the benefits of health interventions and misallocate resources toward interventions with lower comprehensive effects. We discuss the implications of social spillovers for program evaluation and document the first evidence of causal spillovers of health behaviors between spouses by leveraging experimental data from the Lung Health Study (smoking) and COMBINE Study (drinking). Read More

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http://dx.doi.org/10.1257/pol.20150573DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6063372PMC
November 2017
1 Read

The Evolution of Physician Practice Styles: Evidence from Cardiologist Migration.

Authors:
David Molitor

Am Econ J Econ Policy 2018 Feb;10(1):326-356

University of Illinois at Urbana-Champaign, 1206 S. Sixth Street, Champaign, IL 61820 and National Bureau of Economic Research (NBER).

Physician treatment choices for observably similar patients vary dramatically across regions. This paper exploits cardiologist migration to disentangle the role of physician-specific factors such as preferences and learned behavior versus environment-level factors such as hospital capacity and productivity spillovers on physician behavior. Physicians starting in the same region and subsequently moving to dissimilar regions practice similarly before the move. Read More

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http://dx.doi.org/10.1257/pol.20160319DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5876705PMC
February 2018
2 Reads

Capacity and Utilization in Health Care: The Effect of Empty Beds on Neonatal Intensive Care Admission.

Authors:
Seth Freedman

Am Econ J Econ Policy 2016 May;8(2):154-185

School of Public and Environmental Affairs, Indiana University, 1315 E. 10th St., Bloomington, IN 47401, .

Because geographic variation in medical care utilization is jointly determined by both supply and demand, it is difficult to empirically estimate whether capacity itself has a causal impact on utilization in health care. In this paper, I exploit short-term variation in Neonatal Intensive Care Unit (NICU) capacity that is unlikely to be correlated with unobserved demand determinants. I find that available NICU beds have little to no effect on NICU utilization for the sickest infants, but do increase utilization for those in the range of birth weights where admission decisions are likely to be more discretionary. Read More

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http://pubs.aeaweb.org/doi/10.1257/pol.20120393
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http://dx.doi.org/10.1257/pol.20120393DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5142636PMC
May 2016
1 Read

The Effects of Medicare on Medical Expenditure Risk and Financial Strain.

Am Econ J Econ Policy 2015 Nov;7(4):41-70

The Paul Merage School of Business, University of California, Irvine, CA 92697-3125 and National Bureau of Economic Research (NBER) ( ).

Medicare offers substantial protection from medical expenditure risk, protection that has increased in recent years. At age 65, out-of-pocket expenditures drop by 33 percent at the mean and 53 percent at the ninety-fifth percentile. Medical-related financial strain, such as difficulty paying bills and collections agency contact, is dramatically reduced. Read More

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http://dx.doi.org/10.1257/pol.20140262DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5137378PMC
November 2015

Health Insurance Mandates, Mammography, and Breast Cancer Diagnoses.

Am Econ J Econ Policy 2016 Aug;8(3):39-68

Department of Economics, Vanderbilt University, 2301 Vanderbilt Place, PMB 351819, Nashville, TN 37235-1819.

We examine the effects of state health insurance mandates requiring coverage of screening mammograms. We find evidence that mammography mandates significantly increased mammography screenings by 4.5-25 percent. Read More

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http://pubs.aeaweb.org/doi/10.1257/pol.20120298
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http://dx.doi.org/10.1257/pol.20120298DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5844506PMC
August 2016
4 Reads

Why Is Infant Mortality Higher in the United States Than in Europe?

Am Econ J Econ Policy 2016 May;8(2):89-124

MIT and NBER.

The US has higher infant mortality than peer countries. In this paper, we combine micro-data from the US with similar data from four European countries to investigate this US infant mortality disadvantage. The US disadvantage persists after adjusting for potential di erential reporting of births near the threshold of viability. Read More

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http://dx.doi.org/10.1257/pol.20140224DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4856058PMC
May 2016
4 Reads

Paying on the margin for medical care: Evidence from breast cancer treatments.

Am Econ J Econ Policy 2016 Feb;8(1):52-79

MIT and NBER.

We present a simple graphical framework to illustrate the potential welfare gains from a "top-up" health insurance policy requiring patients to pay the incremental price for more expensive treatment options. We apply this framework to breast cancer treatments, where lumpectomy with radiation therapy is more expensive than mastectomy but generates similar average health benefits. We estimate the relative demand for lumpectomy using variation in distance to the nearest radiation facility, and estimate that the "top-up" policy increases social welfare by $700-2,500 per patient relative to two common alternatives. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4758371PMC
February 2016

The Best of Times, the Worst of Times: Understanding Pro-cyclical Mortality.

Am Econ J Econ Policy 2015 Nov;7(4):279-311

University of California, Davis, 1 Shields Ave., Davis, CA 95616.

It is well known that mortality rates are pro-cyclical. In this paper, we attempt to understand why. We find little evidence that cyclical changes in individuals' own employment-related behavior drives the relationship; own-group employment rates are not systematically related to own-group mortality. Read More

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http://dx.doi.org/10.1257/pol.20130057DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6028024PMC
November 2015

Returns to Treatment in the Formal Health Care Sector: Evidence from Tanzania.

Am Econ J Econ Policy 2015 Aug;7(3):29-57

University of Southern California.

Improving access to the formal health care sector is a primary public health goal in many low-income countries. But the returns to this access are unclear, given that the quality of care at public health facilities is often considered inadequate. We exploit temporal and geographic variation in the cost of traveling to formal sector health facilities to show that treatment at these facilities improves short-term health outcomes for acutely ill children in Tanzania. Read More

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http://dx.doi.org/10.1257/pol.20120262DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4521447PMC
August 2015
2 Reads

Is there a Link Between Foreclosure and Health?

Am Econ J Econ Policy 2015 Feb;7(1):63-94

Department of Economics, Georgia State University.

We investigate the relationship between foreclosures and hospital visits using data on all foreclosures and all hospital and emergency room visits from four states that were among the hardest hit by the foreclosure crisis. We find that living in a neighborhood with a spike in foreclosures is associated with significant increases in urgent unscheduled visits, including increases in visits for preventable conditions. The estimated relationships cannot be accounted for by increasing unemployment, declines in housing prices, migration, or by people switching from out-patient providers to hospitals. Read More

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http://dx.doi.org/10.1257/pol.20120325DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4933518PMC
February 2015
2 Reads

Early Retirement Incentives and Student Achievement.

Am Econ J Econ Policy 2014 Aug;6(3):120-154

Department of Policy Analysis and Management, Cornell University and NBER. Mail: 135 Martha Van Rensselaer Hall, Ithaca, NY 14853.

Early retirement incentives (ERIs) are increasingly prevalent in education as districts seek to close budget gaps by replacing expensive experienced teachers with lower-cost newer teachers. Combined with the aging of the teacher workforce, these ERIs are likely to change the composition of teachers dramatically in the coming years. We use exogenous variation from an ERI program in Illinois in the mid-1990s to provide the first evidence in the literature of the effects of large-scale teacher retirements on student achievement. Read More

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http://dx.doi.org/10.1257/pol.6.3.120DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4244602PMC

Check in the Mail or More in the Paycheck: Does the Effectiveness of Fiscal Stimulus Depend on How It Is Delivered?

Am Econ J Econ Policy 2012 Aug;4(3):216-50

Sahm: Federal Reserve Board, Washington, DC 20551 ( ); Shapiro: Department of Economics, University of Michigan, Ann Arbor, MI 48109 ( ); Slemrod: Department of Economics, University of Michigan, Ann Arbor, MI 48109 ( ).

Recent fiscal policies, including the 2008 stimulus payments and the 2009 Making Work Pay Tax Credit, aimed to increase household spending. This paper quantifies the spending response to these policies and examines differences in spending by whether the stimulus was delivered as a one-time payment or as a flow of payments from reduced withholding. Based on responses from a representative sample of households in the Thomson Reuters University of Michigan Surveys of Consumers, the paper finds that the reduction in withholding in 2009 boosted spending at roughly half the rate (13 percent) as the one-time payments (25 percent) in 2008. Read More

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http://dx.doi.org/10.1257/pol.4.3.216DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3747574PMC
August 2012
4 Reads

Personal Retirement Accounts and Saving.

Authors:
Emma Aguila

Am Econ J Econ Policy 2011 Nov;3(4):1-24

RAND, 1776 Main Street, Santa Monica, CA 90407.

Aging populations are leading countries worldwide to social security reforms. Many countries are moving from pay-as-you-go to personal retirement account (PRA) systems because of their financial sustainability and positive impact on private savings. PRA systems boost private savings at a macro level by converting a government liability into financial wealth managed by private fund managers. Read More

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http://dx.doi.org/10.1257/pol.3.4.1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5345943PMC
November 2011
4 Reads
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