Does Health Insurance Promote Health through Providers and Networks?

其他项目信息-项目概要/摘要 健康保险通过提供者和网络促进健康吗？ 通过其不同的供应商网络和覆盖范围，健康保险计划直接和间接地引导 患者倾向于一些临床医生和医院，而远离其他人。如果供应商的质量不同， 护理，特别是如果他们为某些类型的患者提供更好的护理，这种网络变化可以 对计划层面的健康结果产生有意义的影响，而不仅仅是提供者层面。然而，消费者 选择健康计划缺乏关于哪些计划将指导他们更好的提供者的信息， 这是改善人口健康的潜在重要渠道。 该项目将根据以下方面开发新的基于结果的保险计划质量衡量标准： 参与者接受护理，并考虑到对健康的因果影响在提供者网络之间的差异。通过 进一步科学地理解提供者质量和患者结果之间的关系， 在计划层面，我们的目标是为病人提供选择保险计划的新资料。我们的措施 还将为监管机构提供新的工具，以奖励使人们更健康的计划。 我们研究计划的核心是对不同医院的死亡率影响进行新的因果估计 和医生，反过来，在整个健康计划，依赖于不同的提供商网络。我们专注于 老年美国人参加了Medicare Advantage计划，利用提供商网络上的新数据 使用不同的Medicare Advantage计划。这些估计将描述哪些医院和供应商 为具有不同人口统计学特征和合并症的受益人产生最佳结果， 计划是适合每一种类型的病人，通过指导他们提供谁产生良好的结果， 他们所面临的或可能面临的问题。 该项目有四个主要目标： 目标1：测量和预测医疗保健提供者的死亡率影响 目标2：将医生和医院死亡率影响与计划死亡率影响联系起来 目标3：探索受益人之间死亡率影响的异质性 目标4：评估政策建议的影响

OTHER PROJECT INFORMATION – Project Summary/Abstract Does Health Insurance Promote Health through Providers and Networks? Through their varying provider networks and coverages, health insurance plans directly and indirectly steer patients toward some clinicians and hospitals and away from others. If providers differ in their quality of care and especially if they provide better care for certain types of patients, such network variation can meaningfully affect health outcomes at the plan level, and not just the provider level. Yet, consumers selecting health plans lack information about which plans will direct them to better providers, obscuring this potentially important channel to improving population health. This project will develop novel outcome-based measures of insurance plan quality based on where enrollees receive care, and taking account how causal impacts on health vary across provider networks. By furthering the scientific understanding of the relationship between provider quality and patient outcomes at the plan level, we aim to equip patients with new information for selecting insurance plans. Our measures will also provide regulators with new instruments to reward plans that make people healthier. At the core of our research plan are new, causal estimates of how mortality impacts vary across hospitals and physicians and, in turn, across the health plans that rely on different provider networks. We focus on older Americans enrolled in Medicare Advantage plans, leveraging novel data on the provider networks used by different Medicare Advantage plans. The estimates will characterize which hospitals and providers produce the best outcomes for beneficiaries with different demographics and comorbidities and thus which plans are suitable for each type of patient by directing them to providers who produce good outcomes for conditions they have or are likely to develop. The project has four primary aims: Aim 1: Measure and Validate Mortality Effects for Healthcare Providers Aim 2: Link Physician and Hospital Mortality Effects to Plan Mortality Effects Aim 3: Explore Heterogeneity in Mortality Effects Across Beneficiaries Aim 4: Evaluate the Impact of Policy Proposals