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The Impact of Increased Cost-sharing on Utilization of Low Value Services: Evidence from the State of Oregon

Jonathan Gruber (), Johanna Maclean, Bill J. Wright, Eric S. Wilkinson and Kevin Volpp

No 22875, NBER Working Papers from National Bureau of Economic Research, Inc

Abstract: In this study we examine the impact of a value-based insurance design (V-BID) program implemented between 2010 and 2013 at a large public employer in the state of Oregon. The program substantially increased cost-sharing, specifically copayments and coinsurance, for several healthcare services believed to be of low value and overused (sleep studies, endoscopies, advanced imaging, and surgeries). Using a differences-in-differences design coupled with granular, administrative health insurance claims data, we estimate the change in low value healthcare service utilization among beneficiaries before and after program implementation relative to a comparison group of beneficiaries who were not exposed to the V-BID. Our findings suggest that the V-BID significantly reduced utilization of targeted services. These findings have important implications for both public and private healthcare policies as V-BID principles are rapidly proliferating in healthcare markets.

JEL-codes: I1 I11 I13 (search for similar items in EconPapers)
New Economics Papers: this item is included in nep-ias
Date: 2016-12
Note: HC HE
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Working Paper: The Impact of Increased Cost-Sharing on Utilization of Low Value Services: Evidence from the State of Oregon (2017) Downloads
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