Managed care, drug benefits and mortality
Subtitle: an analysis of the elderly
By: Gautam Gowrisankaran, Robert J. Town.
Contributors: Town, Robert J.; National Bureau of Economic Research.
Series: NBER working paper series ;; working paper 10204; Working paper series (National Bureau of Economic Research : Online) ;; working paper no. 10204.
Publisher: National Bureau of Economic Research
Published: 2004
Place of publication: Cambridge, MA
Language: eng
Format: Electronic resource
Subjects: Managed care plans (Medical care); Mortality; Drugs -- Prescribing; Insurance, Pharmaceutical services; Older people -- Pharmaceutical assistance
Description: "We seek to investigate whether managed health care can affect mortality, and if so, through which mechanisms.  We estimate the impact of Medicare+Choice (M+C), Medicare's managed care program, on elderly mortality, using a county-level panel from 1993 to 2000.  We control for endogenous M+C penetration rates with county fixed effects and instrumental variables.  We construct instruments using the identification created by the fact that M+C payment rates are based on 3 to 8 year lagged fee-for-service (FFS) costs in the county.  We find that enrollment in managed care without prescription drug coverage significantly increases mortality while enrollment in managed care with drug coverage has no significant impact, both relative to FFS.  The impact of managed care penetration on mortality from heart disease appears to follow a similar pattern.  The estimates suggest that a 10-percentage point increase in M+C non-drug coverage would cause 51,000 additional deaths among the aged population in 2000"--National Bureau of Economic Research web site.
Notes: Includes bibliographical references.
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