Predictability and predictiveness in health care spending
Predictability and predictiveness in health care spending
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DOI：
10.1016/j.jhealeco.2006.06.004
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发表时间：
2007-01-01
影响因子：
3.5
通讯作者：
McGuire, Thomas G.
中科院分区：
文献类型：
--
作者：
Ellis, Randall P.;McGuire, Thomas G.
本文重新考察了医疗支出的可预测性与逆向选择激励之间的关系。在一个关于服务水平的健康计划决策的明确模型中，我们展示了可预测性（某些服务的预期支出有多高）、可预测性（某些服务的预测水平与医疗保健总支出同时共变的程度有多高）和需求响应性对逆向选择激励都很重要。涉及可预测性、可预测性和需求响应这三种度量的术语的乘积定义了选择激励的方向和大小的经验指数。我们量化了在医疗保险中不同类型的医疗服务中逆向选择激励的相对大小。我们的结果与其他关于服务水平选择的研究是一致的。激励指数可以很容易地应用于其他支付方的数据。(c) 2006 Elsevier B.V.版权所有
This paper re-examines the relation between the predictability of health care spending and incentives due to adverse selection. Within an explicit model of health plan decisions about service levels, we show that predictability (how well spending on certain services can be anticipated), predictiveness (how well the predicted levels of certain services contemporaneously co-vary with total health care spending), and demand responsiveness all matter for adverse selection incentives. The product of terms involving these three measures of predictability, predictiveness, and demand responsiveness define an empirical index of the direction and magnitude of selection incentives. We quantify the relative magnitude of adverse selection incentives bearing on various types of health care services in Medicare. Our results are consistent with other research on service-level selection. The index of incentives can readily be applied to data from other payers. (c) 2006 Elsevier B.V. All rights reserved.