Please join us for the next
Health Policy Workshop with:
Boris Vabson
Visiting Scholar at TDI,
PhD Candidate at Wharton School, University of Pennsylvania,
& Research Fellow at NBER and Leonard Davis Institute
Is Managed Care Efficiency-Improving and do Patients Benefit? Evidence from New York Medicaid
Date & Time: Thursday, December 18 from 12:00 - 1:15 PM Location: Class of 1930 Room, Nelson A. Rockefeller Center Download to Calendar:
Click Here
Abstract
The extent to which managed care produces efficiency gains (relative to fee-for-service) is not been well-understood; further, the extent to which incomplete contracting and imperfect competition could limit the pass-through
of efficiency gains to patients and governments is not well-identified. I examine these questions by looking to disabled Medicaid recipients in New York State, many of whom were involuntarily shifted from fee-for-service to managed care provision through enrollment
mandates, and all of whom were automatically shifted from managed care to fee-for-service at the age of 65; for identification, I exploit these involuntary shifts between Medicaid managed care & fee-for-service. I also leverage unique administrative data,
which longitudinally tracks individual hospital utilization across the fee-for-service and managed care settings. I find no evidence that managed care yields efficiency improvements and instead find evidence of increased inpatient hospital utilization, reduced
preventative care, and reduced access to outpatient providers. Furthermore, consistent with existing contracting theory, I find that plans shift costs to medical services that are situated outside the scope of plan contracts and which remain the financial
responsibility of New York State.
Biography
Boris Vabson is a Ph.D. Candidate in Applied Economics at Wharton and a Pre-Doctoral Research Fellow at NBER. His research deals with the dynamics of privatization within Medicaid and Medicare, as well as the treatment of dual-eligibles
in these programs. Additional research interests include the impact of competition within health care and the dynamics of health insurance exchanges. Boris received his A.B. in Economics and Mathematics from Dartmouth College, graduating Phi Beta Kappa and
Magna Cum Laude, with High Honors in Economics.