Randomized trial shows healthcare payment reform has equal-sized spillover effects on patients not targeted by reform

Liran Einav, Amy Finkelstein (), Yunan Ji and Neale Mahoney
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Amy Finkelstein: National Bureau of Economic Research, Cambridge, MA 02138; Department of Economics, Massachusetts Institute of Technology, Cambridge, MA 02139
Neale Mahoney: Department of Economics, Stanford University, Stanford, CA 94305; National Bureau of Economic Research, Cambridge, MA 02138

Proceedings of the National Academy of Sciences, 2020, vol. 117, issue 32, 18939-18947

Abstract: Changes in the way health insurers pay healthcare providers may not only directly affect the insurer’s patients but may also affect patients covered by other insurers. We provide evidence of such spillovers in the context of a nationwide Medicare bundled payment reform that was implemented in some areas of the country but not in others, via random assignment. We estimate that the payment reform—which targeted traditional Medicare patients—had effects of similar magnitude on the healthcare experience of nontargeted, privately insured Medicare Advantage patients. We discuss the implications of these findings for estimates of the impact of healthcare payment reforms and more generally for the design of healthcare policy.

Keywords: bundled payments; healthcare; randomized controlled trial; spillover (search for similar items in EconPapers)
Date: 2020
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Citations: View citations in EconPapers (3)

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