DO HMO PLANS REDUCE HEALTH CARE EXPENDITURE IN THE PRIVATE SECTOR?
2007; Wiley; Volume: 45; Issue: 1 Linguagem: Inglês
10.1093/ei-cbl008
ISSN1465-7295
Autores Tópico(s)Healthcare Systems and Reforms
ResumoEconomic InquiryVolume 45, Issue 1 p. 82-99 DO HMO PLANS REDUCE HEALTH CARE EXPENDITURE IN THE PRIVATE SECTOR? JAEUN SHIN, JAEUN SHIN Shin: Assistant Professor, KDI School of Public Policy and Management, 207-43 Cheongnyangri2-Dong, Dongdaemoon-Gu, Seoul 130-868, Korea. Phone 82-2-3299-1037, Fax 82-2-3299-1129, E-mail [email protected]Search for more papers by this authorSANGHO MOON, SANGHO MOON Moon: Associate Professor, Sungkyunkwan University, Graduate School of Governance, 53 Myeongnyun-Dong 3-Ga, Jongno-Gu, Seoul 110-745, Korea. Phone 82-2-760-0367, Fax 82-2-760-1311, E-mail [email protected]Search for more papers by this author JAEUN SHIN, JAEUN SHIN Shin: Assistant Professor, KDI School of Public Policy and Management, 207-43 Cheongnyangri2-Dong, Dongdaemoon-Gu, Seoul 130-868, Korea. Phone 82-2-3299-1037, Fax 82-2-3299-1129, E-mail [email protected]Search for more papers by this authorSANGHO MOON, SANGHO MOON Moon: Associate Professor, Sungkyunkwan University, Graduate School of Governance, 53 Myeongnyun-Dong 3-Ga, Jongno-Gu, Seoul 110-745, Korea. Phone 82-2-760-0367, Fax 82-2-760-1311, E-mail [email protected]Search for more papers by this author First published: 27 August 2009 https://doi.org/10.1093/ei-cbl008Citations: 2Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat Abstract The cost containment performance of health maintenance organization (HMO) plans relative to non-HMOs is examined using data from the 2000 Medical Expenditure Panel Survey. When various compounding factors are controlled for, among the privately insured, nonelderly population, HMO enrollment is found to contain neither total health care spending nor total insurance payment, though it reduces total out-of-pocket expenditure. We further find that this result is not attributed to selectivity in health plan choice due to health risk. The favorable cost sharing for enrollees and the distinct reimbursement schemes in HMO plans seem to account for no significant overall cost saving. (JEL I11, C25) References Anderson, R., and L. A. Aday. “Access to Medical Care in the U.S.: Realized and Potential.” Medical Care, 16, 1978, 533–46. 10.1097/00005650-197807000-00001 CASPubMedWeb of Science®Google Scholar Baker, L., and K. Corts. “HMO Penetration and the Cost of Health Care: Market Discipline or Market Segmentation.” American Economic Review, 86(2), 1996, 389–94. CASPubMedWeb of Science®Google Scholar Buchanan, J. L., and S. Cretin. “Risk Selection of Families Electing HMO Membership.” Medical Care, 24(1), 1986, 39–51. 10.1097/00005650-198601000-00005 PubMedWeb of Science®Google Scholar Buchanan, J. L., A. Leibowitz, and J. Keesey. “Medicaid Health Maintenance Organizations. Can They Reduce Program Spending?” Medical Care, 34(3), 1996, 249–63. 10.1097/00005650-199603000-00005 PubMedWeb of Science®Google Scholar Cameron, A. C., P. K. Trivedi, F. Milne, and J. Piggott. “A Microeconometric Model of the Demand for Health Care and Health Insurance in Australia.” Review of Economic Studies, 55, 1988, 85–106. 10.2307/2297531 Web of Science®Google Scholar Cohen, J. W., A. C. Monheit, K. M. Beauregard, S. B. Cogen, D. C. Lefkowitz, D. E. Potter, J. P. Sommers, A. K. Taylor, and R. H. Arnett. “The Medical Expenditure Panel Survey: A National Health Information Resource.” Inquiry, 33(4), 1996, 373–89. PubMedWeb of Science®Google Scholar Cohen, S. B. “Sample Design of the 1997 Medical Expenditure Panel Survey Household Component.” Agency for Healthcare Research and Quality, MEPS Methodology Report No. 11. AHRQ Publication No. 01-0001, 2000. Rockville, MD. Google Scholar Dowd, B., R. Feldman, S. Cassou, and M. Finch. “Health Plan Choice and the Utilization of Health Care Services.” Review of Economics and Statistics, 73(1), 1991, 85–93. 10.2307/2109690 Web of Science®Google Scholar Feldman, R., B. Dowd, and G. Gifford. “The Effect of HMOs on Premiums in Employment-based Health Plans.” Health Services Research, 27(6), 1993, 779–81. CASPubMedWeb of Science®Google Scholar Gilleskie, D. “Dynamic Stochastic Model of Medical Care Use and Work Absence.” Econometrica, 66(1), 1998, 1–45. 10.2307/2998539 Web of Science®Google Scholar Glied, S. A. “Managed Care, ” in Handbook of Health Economics, edited by A. J. Culyer and J. P. Newhouse. New York: Elsevier Science, 2000, 707–45. 10.1016/S1574-0064(00)80172-9 Google Scholar Health, United States, 2003 with Chartbook on Trends in the Health of Americans. GPO Stock number 017-022-01546-3, National Center for Health Statistics, Centers for Disease Control and Prevention, Department of Health and Human Services, 2003. www.cdc.gov/nchs/data/hus/hus03.pdf. Google Scholar Hunt-McCool, J., B. F. Kiker, and Y. C. Ng. “Estimates of the Demand for Medical Care under Different Functional Forms.” Journal of Applied Econometrics, 9(2), 1994, 201–18. 10.1002/jae.3950090206 Web of Science®Google Scholar Jackson-Beeck, M. and J. H. Kleinman. “Evidence for Self-Selection among Health Maintenance Organization Enrollees.” Journal of the American Medical Association, 250(20), 1983, 2826–29. 10.1001/jama.250.20.2826 CASPubMedWeb of Science®Google Scholar Johnson, A. N., and D. Aquilina. “The Impact of Health Maintenance Organizations and Competition on Hospitals in Minneapolis/St. Paul.” Journal of Health Politics Policy Law, 10(4), 1986, 659–74. 10.1215/03616878-10-4-659 PubMedWeb of Science®Google Scholar Kralewski, J. E., E. C. Rich, R. Feldman, B. E. Dowd, T. Bernhardt, C. Johnson, and W. Gold. “The Effects of Medical Group Practice and Physician Payment Methods on Costs of Care.” Health Services Research, 35(3), 2000, 591–613. PubMedWeb of Science®Google Scholar Ligon, J. “The Effect of Health Insurance Cost Sharing within Episodes of Medical Care.” Journal of Risk and Insurance, 60(1), 1993, 105–18. 10.2307/253101 Web of Science®Google Scholar Ligon, J. “Fee-for-Service versus HMO Outpatient Expenditure Patterns.” Journal of Risk and Insurance, 61(1), 1994, 96–106. 10.2307/253426 Web of Science®Google Scholar Machlin, S. R., and A. K. Taylor. “Designs, Methods, and Field Results of the 1996 Medical Expenditure Panel Survey Medical Provider Component.” Agency for Healthcare Research and Quality, MEPS Methodology Report No. 9. AHRQ Publication No. 00-0028, 2000. Rockville, MD. Web of Science®Google Scholar Manning, W. G., J. P. Newhouse, N. Duan, E. B. Keeler, and A. Leibowiz. “Health Insurance and the Demand for Medical Care: Evidence from a Randomized Experiment.” American Economic Review, 77(3), 1987, 251–77. CASPubMedWeb of Science®Google Scholar McLaughlin, C. G. “HMO Growth and Hospital Expenses and Use: A Simultaneous Equation Approach.” Health Services Research, 22(2), 1987, 183–205. PubMedWeb of Science®Google Scholar McLaughlin, C. G., J. C. Merrill, and A. J. Freed. “The Impact of HMO Growth on Hospital Costs and Utilization.” Advances in Health Economics and Health Services Research, 5, 1983, 57–93. Google Scholar Mello, M., S. Stearns, and E. Norton. “Do Medicare HMOs still Reduce Health Services Use after Controlling for Selection Bias? ” Health Economics, 11, 2002, 323–40. 10.1002/hec.664 PubMedWeb of Science®Google Scholar Miller, R. and H. Luft. “Managed Care Plan Performance since 1980: A Literature Analysis.” Journal of the American Medical Association, 271(19), 1994, 1512–19. CASPubMedWeb of Science®Google Scholar Miller, R. and H. Luft. “HMO Plan Performance Update: An Analysis of the Literature, 1997–2001.” Health Affairs, 21(4), 2002, 63–86. 10.1377/hlthaff.21.4.63 PubMedWeb of Science®Google Scholar Nicholson, S., M. K. Bundorf, R. M. Stein, and D. Polsky. “The Magnitude and Nature of Risk Selection in Employer-Sponsored Health Plans.” National Bureau of Economic Research Working Paper 9937, 2003. 10.3386/w9937 Google Scholar Polsky, D., and S. Nicholson. “Why Are Managed Care Plans Less Expensive: Risk Selection, Utilization, or Reimbursement?” Journal of Risk and Insurance, 71(1), 2004, 21–40. 10.1111/j.0022-4367.2004.00077.x Web of Science®Google Scholar Robinson, J. C. “Decline in Hospital Utilization and Cost Inflation under Managed Care in California.” Journal of the American Medical Association, 276(13), 1996, 1060–64. 10.1001/jama.276.13.1060 CASPubMedWeb of Science®Google Scholar Shin, J., and S. Moon. “HMO Plans, Self-Selection, and Utilization of Health Care Services.” Applied Economics, forthcoming. Google Scholar Taylor, A. K., K. M. Beauregard, and J. P. Vistnes. “Who Belongs to HMOs: A Comparison of Fee-for-Service versus HMO Enrollees.” Medical Care Research and Review, 52(3), 1995, 389–408. 10.1177/107755879505200304 PubMedWeb of Science®Google Scholar Terza, J. V. “Estimating Count Models with Endogenous Switching: Sample Selection and Endogenous Treatment Effects.” Journal of Econometrics, 84, 1998, 129–54. 10.1016/S0304-4076(97)00082-1 Web of Science®Google Scholar Tu, H. T., P. Kemper, and H. J. Wong. “Do HMOs Make a Difference? Use of Health Services.” Inquiry—The Journal of Health Care Organization Provision and Financing, 36(4), 1999, 400–410. Web of Science®Google Scholar Tudor, C. G., G. Riley, and M. Ingber. “Satisfaction with Care: Do Medicare HMOs Make a Difference?” Health Affairs, 17(2), 1998, 165–76. 10.1377/hlthaff.17.2.165 PubMedWeb of Science®Google Scholar Vuong, Q. “Likelihood Ratio Tests for Model Selection and Non-Nested Hypotheses.” Econometrica, 57, 1989, 307–34. 10.2307/1912557 Web of Science®Google Scholar Wooldridge, J. M. “Quasi-Likelihood Methods for Count Data, ” in Handbook of Econometrics, vol. 2, edited by Pesaran M.H. and P. Schmidt. Oxford: Black-well, 1997, 352–406. Google Scholar Citing Literature Volume45, Issue1January 2007Pages 82-99 ReferencesRelatedInformation
Referência(s)