Health Spending by State of Residence, 1991–2009

Cuckler, Gigi A.; Martin, Anne; Whittle, Lekha; Heffler, Stephen; Sisko, Andrea M.; Lassman, Dave; Benson, Joseph

doi:10.5600/mmrr.001.04.a03

Cited by 32 publications

(34 citation statements)

References 16 publications

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“…equalizing effects of grants and prevented convergence in PWEL. Lastly, SLGs vary in terms of demographic factors, such as the age composition of population and the percent of women of childbearing age and African American, which significantly affect the demand for health care services provided by Medicaid (Cuckler et al 2011).…”

Section: Full Panel Resultsmentioning

confidence: 99%

Are state–local government expenditures converging? New evidence based on sequential unit root tests

Mahdavi

Westerlund

2016

Empir Econ

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Large and persistent gaps in subnational public expenditure have important implications regarding growth, equity, and migration. In this context, we revisit the question of expenditure convergence across the American states to provide more nuanced evidence than found by a small number of previous studies. We employ a methodology due to Smeekes (Bootstrap sequential tests to determine the stationary units in a panel, 2011) that sequentially tests for unit roots in pairwise (real per capita) expenditure gaps based on user specified fractions. In a panel of 48 combined state-local government units , we found that expenditures on highways, sanitation, utility, and education were far more convergent than expenditures on health and hospitals, police and fire protection, and public welfare. There was little evidence of "club convergence" based on the proportion of intraregional convergent pairs. Several historically high-grant receiving states showed relatively strong evidence of convergence. Our results bode well for future output convergence and opportunities for Tiebout-type migration across jurisdictions. They also imply a diminished role for public infrastructure and education spending in business location choices over time and a mixed role for federal grants in inducing convergence.

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Section: Full Panel Resultsmentioning

confidence: 99%

Are state–local government expenditures converging? New evidence based on sequential unit root tests

Mahdavi

Westerlund

2016

Empir Econ

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“…Expenditures per enrollee for Medicare were $8326 in Utah and $10,365 in the nation. Expenditures per enrollee for Medicaid were $7293 in Utah and $6826 in the nation (Cuckler et al 2011). Do the first two reflect Utah's efficiency, or the relative youth of Utah's population?…”

Section: Healthmentioning

confidence: 99%

Utah’s 2012 Legislature Holds Its Course – with What Foresight?

Huefner¹

2013

California Journal of Politics and Policy

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Abstract:Utah's legislative session ended Thursday, March 9, 2013. The ship of state made little change in course. It sliced through waters calmed in part by appropriations of $13 billion, at or near a new post-recession total. Contentions over the sources and uses of funds were limited, as the legislature steered clear of big changes. Debates (nay, pronouncements) instead built election-year themes: bash the federal government and fight (or hide) sex. This budget report focuses upon the legislative session, the allocation of benefits and burdens. Session SummaryWhen Utah's 2012 legislative session ended in March, The Salt Lake Tribune summarized it as, "45 days of efficient law-making, angry fist-shaking at the federal government, conservative cause-pushing and the meting out of more cash than the state has seen in several years. It was an otherwise mundane session without scandal or public furor" (Gehrke 2012c,d). The next day the Tribune, a progressive (and the state's largest) paper opined the "Utah budget a reasonable plan." (Salt Lake Tribune 2012c) The ship of state made little change in course. It sliced through waters calmed in part by appropriations of $13 billion, at or near a new post-recession total. Contentions over the sources and uses of funds were limited, as the legislature steered clear of big changes. Debates (nay, pronouncements) instead built election-year themes: bash the federal government and fight (or hide) sex.Who frames the budget's focus and discussion? To what extent should the legislature, the press, and/or the public decide what is considered? Should, and can, attention be more certainly and usefully shifted to fiscal affairs? Does Utah's reputation for good financial management mean discussion is adequate and well-focused? Fiscal issues decided this year show varying degrees of legislative

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“…In December 2011, the Office of the Actuary (OACT) in the Centers for Medicare & Medicaid Services (CMS) contributed to this research by releasing updated estimates of state health expenditure data for 1991-2009 and, for the first time in OACT's history, an econometric model to explain variation in total per capita personal health care spending across states over that period (Cuckler, et al, 2011). The purpose of the model was to further substantiate the findings of OACT's descriptive analysis of the macroeconomic and population-level factors that contribute to substantial variation observed in per capita personal health care spending 1 levels by state (Exhibit 1).…”

Section: Introductionmentioning

confidence: 99%

“…In this paper, the methodology underlying OACT's econometric analysis of state health spending variation referenced in Cuckler et al (2011) is described in greater detail. Thus, this paper contains a discussion of the relevant literature, methodological challenges, the data sources for the model, the econometric techniques and statistical tests used in the development of the published model, a sensitivity analysis, the results and implications of this analysis, limitations of the model, and areas for future research.…”

Section: Introductionmentioning

confidence: 99%

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mentioning

confidence: 99%

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Modeling Per Capita State Health Expenditure Variation: State-Level Characteristics Matter

Cuckler¹,

Sisko²

2013

MMRR

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Objective:In this paper, we describe the methods underlying the econometric model developed by the Office of the Actuary in the Centers for Medicare & Medicaid Services, to explain differences in per capita total personal health care spending by state, as described in Cuckler, et al. (2011). Additionally, we discuss many alternative model specifications to provide additional insights for valid interpretation of the model. Principal Findings: State-specific factors, such as income, health care capacity, and the share of elderly residents, are important factors in explaining the level of per capita personal health care spending variation among states over time. However, the slow-moving nature of health spending per capita and close relationships among state-level factors create inefficiencies in modeling this variation, likely resulting in incorrectly estimated standard errors. In addition, we find that both pooled and fixed effects models primarily capture cross-sectional variation rather than period-specific variation. Keywords

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Health Spending by State of Residence, 1991–2009

Cited by 32 publications

References 16 publications

Are state–local government expenditures converging? New evidence based on sequential unit root tests

Are state–local government expenditures converging? New evidence based on sequential unit root tests

Utah’s 2012 Legislature Holds Its Course – with What Foresight?

Modeling Per Capita State Health Expenditure Variation: State-Level Characteristics Matter

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