The effects of medicare advantage on opioid use

Abstract

We would like to thank Joel Ferguson and Grant Vaska for exceptional research support, and seminar participants at Stanford and Dartmouth for helpful comments. The views expressed herein are those of the authors and do not necessarily reflect the views of the National Bureau of Economic Research. At least one co-author has disclosed a financial relationship of potential relevance for this research. Further information is available online at http://www.nber.org/papers/w25327.ack NBER working papers are circulated for discussion and comment purposes. They have not been peer-reviewed or been subject to the review by the NBER Board of Directors that accompanies official NBER publications.

The Economics Behind the Epidemic: Afghan Opium Price and Prescription Opioids in the US

“…Also, wealthier and urbanized areas, which typically feature a higher share of residents with health insurance, display lower impact of opium price changes on the dispensation of opioid-based drugs, in line with the empirical evidence provided by Krueger (2017). This result also confirms the recent findings on the effect of Medicare expansion on opioid use by Baker et al (2018), namely that enrolment in the Medicare plan that combines drug coverage with other medical benefits significantly reduces the probability of requests for opioid prescriptions, by comparison with other (stand-alone) drug plans.…”

“…We show that the effect varies with some socio-economic characteristics. In particular, in line with the findings of previous studies (Case and Deaton, 2015;Krueger, 2017;Baker et al, 2018), it is smaller in counties with higher initial levels of income, education, urbanization or health insurance coverage. Conversely, the effect is stronger in areas with a higher initial share of health care workers in the population.…”

Do Larger Health Insurance Subsidies Benefit Patients or Producers? Evidence from Medicare Advantage

“…In addition, our research complements a prior literature that uses discrete choice models to examine the relationship between market power and welfare in Medicare Advantage (Town and Liu 2003;Dunn 2010;Lustig 2010;Curto et al 2015). 5 Our finding of an average premium pass-through of 45 percent, 4 As shown in Fabinger and Weyl (2013b), the incidence or ratio of consumer to producer surplus is given by…”

“…The second part of the paper investigates why consumers receive only one-half of the marginal surplus from this increase in payments. 4 Drawing on prior work by Einav, Finkelstein, and Cullen (2010) and Mahoney and Weyl (2017), we build a model that illustrates that the observed incomplete pass-through could potentially be explained by two factors: the degree of advantageous selection in the market and the market power of private MA insurance plans. If there is substantial advantageous selection into MA, then private plans will not pass through the increased payments in reduced premiums because lower premiums will attract enrollees who are differentially more costly on the margin.…”

The Effects of Becoming a Physician on Prescription Drug Use and Mental Health Treatment

“…High-ability applicants are defined as those in lottery categories B, C, and D, while low-ability applicants are defined as those in categories E and F. 38 For both female 37 Examining the effect of becoming a physician on the probability of using antidepressants in at least two of the 13 years under study produces qualitatively similar results (Appendix Table 3). Other studies on prescription drug use have taken a similar approach to measure potentially problematic use when information on abuse was unavailable (Baker et al 2020;Sacks et al 2021).…”