The effect of increased cost-sharing on low-value service use.
cost-sharing
healthcare
low value
value-based insurance design
Journal
Health economics
ISSN: 1099-1050
Titre abrégé: Health Econ
Pays: England
ID NLM: 9306780
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
received:
22
02
2020
revised:
06
05
2020
accepted:
04
06
2020
pubmed:
21
7
2020
medline:
28
7
2021
entrez:
21
7
2020
Statut:
ppublish
Résumé
We examine the effect of a value-based insurance design (VBID) program implemented at a large public employer in the state of Oregon. The program substantially increased cost-sharing for several healthcare services likely to be of low value for most patients: diagnostic services (e.g., imaging services) and surgeries (e.g., spinal surgeries for pain). Using a difference-in-differences design coupled with granular, administrative health insurance claims data over the period 2008-2012, we estimate the change in low-value service use among beneficiaries before and after program implementation relative to a comparison group not exposed to the VBID. Our findings suggest that the VBID significantly reduced the use of targeted services, with an implied elasticity of demand of -0.22. We find no evidence that the VBID led to substitution to non-targeted services or increased overall healthcare costs. However, we also observe no evidence that the program led to cost-savings.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1180-1201Informations de copyright
© 2020 John Wiley & Sons, Ltd.
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