Changing mix of medical care services: Stylized facts and implications for price indexes

Aizcorbe, Ana; Nestoriak, Nicole

doi:10.1016/j.jhealeco.2011.04.002

Cited by 29 publications

(35 citation statements)

References 10 publications

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“…Overall, our findings are similar to those (Aizcorbe and Nestoriak ; Aizcorbe et al. ) who also found that the MCE grows slower than the SPI.…”

Section: Study Findingssupporting

confidence: 93%

“…Expenditure shifts have been documented and quantified for specific diseases, such as cataracts, heart attacks, and depression . These shifts have also been shown when looking across a broad set of diseases as in the work by Aizcorbe and Nestoriak (), henceforth AN, and Aizcorbe et al. ().…”

Section: Introductionmentioning

confidence: 58%

“…This more appropriately defined price is a combination of procedural prices as well as the utilization of procedures within an episode of care. Indeed, a recent study by Aizcorbe and Nestoriak () shows that not accounting for utilization shifts may result in a health care price measure that overstates price growth, and hence, understates real GDP growth. In this study, we aim to supplement this line of work by providing another measure of health care prices which takes the utilization shifts into account.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Medical Care Price Indexes for Patients with Employer‐Provided Insurance: Nationally Representative Estimates from MarketScan Data

Dunn

Liebman

Pack

et al. 2012

Health Services Research

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“…Overall, our findings are similar to those (Aizcorbe and Nestoriak ; Aizcorbe et al. ) who also found that the MCE grows slower than the SPI.…”

Section: Study Findingssupporting

confidence: 93%

Section: Introductionmentioning

confidence: 58%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Medical Care Price Indexes for Patients with Employer‐Provided Insurance: Nationally Representative Estimates from MarketScan Data

Dunn

Liebman

Pack

et al. 2012

Health Services Research

View full text Add to dashboard Cite

show abstract

“… 1 See, e.g., Bundorf, Royalty, and Baker (2009); Aizcorbe and Nestoriak (2011); Herrera et al (2013); Dunn, Liebman, and Shapiro (2014). There is also significant attention in this literature to whether improvements in health care quality might bias measures of prices: see e.g., Cutler et al (1998, 2001).…”

mentioning

confidence: 99%

The Evolution of Health Insurer Costs in Massachusetts, 2010–2012

Pakes

Shepard

2018

Rev Ind Organ

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We analyze the evolution of health insurer costs in Massachusetts between 2010–2012, paying particular attention to changes in the composition of enrollees. This was a period in which Health Maintenance Organizations (HMOs) increasingly used physician cost control incentives but Preferred Provider Organizations (PPOs) did not. We show that cost growth and its components cannot be understood without accounting for (i) consumers’ switching between plans, and (ii) differences in cost characteristics between new entrants and those leaving the market. New entrants are markedly less costly than those leaving (and their costs fall after their entering year), so cost growth of continuous enrollees in a plan is significantly higher than average per-member cost growth. Relatively high-cost HMO members switch to PPOs while low-cost PPO members switch to HMOs, so the impact of cost control incentives on HMO costs is likely different from their impact on market-wide insurer costs.

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“…5 The U.S. Bureau of Economic Analyses also studied the implementation of specifi c activity indices for health care. 3 The use of performance indicators to assess Brazilian public health organizations is rare. There is a growing trend toward outsourcing clinical laboratory analysis in SUS unmatched by proposals for performance evaluation in both the public network and third-party laboratories.…”

mentioning

confidence: 99%

Indicadores de desempenho e decisão sobre terceirização em rede pública de laboratórios

2012

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OBJECTIVE:To develop performance indicators for outsourcing clinical laboratory services, based on information systems and public administrative records. METHODS:In the municipality of Rio de Janeiro, Southern Brazil, the public health laboratory network comprised 33 laboratories with automated equipment (but no integrated information system), 90 primary care units (where sample collection was performed) and 983 employees. Information records were obtained from the administrative records of the Budget Information System for Public Health and the Outpatient and Hospital Information System of the Unifi ed Health System. Performance indicators (production, productivity, usage and costs) were generated from data collected routinely from 2006 to 2008. The variations in production, costs and unit prices for tests were analyzed by Laspeyres and Paasche indices, which specifi cally measure laboratory activity, and by the Consumer Price Index from the Brazilian Institute of Geography and Statistics. RESULTS:A total of 10,359,111 tests were performed in 2008 (10.6% increase over 2006), and the test/employee ratio grew by 8.6%. The costs of supplies, wages and providers increased by 2.3%, 45.4% and 18.3%, respectively. The laboratory tests per visit and hospitalizations increased by 10% and 20%, respectively. The direct costs totaled R$ 63.2 million in 2008, representing an increase of 22.2% in current values during the period analyzed. The direct costs defl ated by the Brazilian National Consumer Price Index (9.5% for the period) showed an 11.6% increase in production volumes. The activity-specifi c volume index, which considers changes in the mix of tests, showed increases of 18.5% in the test price and 3.1% in the production volume. CONCLUSIONS:The performance indicators, particularly the specifi c indices for volume and price of activity, constitute a baseline of performance potential for monitoring private laboratories and contractors. The economic performance indicators demonstrated the need for network information system integration prior to an outsourcing decision.

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Changing mix of medical care services: Stylized facts and implications for price indexes

Cited by 29 publications

References 10 publications

Medical Care Price Indexes for Patients with Employer‐Provided Insurance: Nationally Representative Estimates from MarketScan Data

Medical Care Price Indexes for Patients with Employer‐Provided Insurance: Nationally Representative Estimates from MarketScan Data

The Evolution of Health Insurer Costs in Massachusetts, 2010–2012

Indicadores de desempenho e decisão sobre terceirização em rede pública de laboratórios

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