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The Impact of Financial Assistance Programs on Health Care Utilization: Evidence from Kaiser Permanente

Author

Listed:
  • Alyce Adams
  • Raymond Kluender
  • Neale Mahoney
  • Jinglin Wang
  • Francis Wong
  • Wesley Yin

Abstract

Most hospitals have financial assistance programs for low-income patients. We use administrative data from Kaiser Permanente to study the effects of financial assistance on health care utilization. Using a regression discontinuity design based on an income threshold for program eligibility, we find that financial assistance increases the likelihood of inpatient, ambulatory, and emergency department encounters by 3.6 pp (59 percent), 13.4 pp (20 percent), and 6.7 pp (53 percent), respectively, though effects dissipate three quarters after program receipt. Financial assistance also increases the detection and management of treatment-sensitive conditions (e.g., drugs treating diabetes), suggesting that financial assistance may increase receipt of high-value care.

Suggested Citation

  • Alyce Adams & Raymond Kluender & Neale Mahoney & Jinglin Wang & Francis Wong & Wesley Yin, 2022. "The Impact of Financial Assistance Programs on Health Care Utilization: Evidence from Kaiser Permanente," American Economic Review: Insights, American Economic Association, vol. 4(3), pages 389-407, September.
    • Handle: RePEc:aea:aerins:v:4:y:2022:i:3:p:389-407
    DOI: 10.1257/aeri.20210515
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    Citations

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    Cited by:

    1. de Bruijn, Ernst-Jan & Vethaak, Heike & Koning, Pierre & Knoef, Marike, 2023. "Debt Relief for the Financially Vulnerable: Impact on Employment, Welfare Receipt, and Mental Health," IZA Discussion Papers 16336, Institute of Labor Economics (IZA).
    2. Shunsuke Imai & Yuta Okamoto, 2023. "Kernel Choice Matters for Boundary Inference Using Local Polynomial Density: With Application to Manipulation Testing," Papers 2306.07619, arXiv.org, revised Jan 2024.
    3. Raymond Kluender & Neale Mahoney & Francis Wong & Wesley Yin, 2024. "The Effects of Medical Debt Relief: Evidence from Two Randomized Experiments," NBER Working Papers 32315, National Bureau of Economic Research, Inc.
    4. Raymond Kluender & Neale Mahoney & Francis Wong & Wesley Yin, 2024. "The Effects of Medical Debt Relief: Evidence from Two Randomized Experiments," CESifo Working Paper Series 11074, CESifo.
    5. Yaa Akosa Antwi & Marion Aouad & Nathan Blascak, 2023. "I've Got 99 Problems But a Bill Ain't One: Hospital Billing Caps and Financial Distress in California," Working Papers 23-20, Federal Reserve Bank of Philadelphia.

    More about this item

    JEL classification:

    • G51 - Financial Economics - - Household Finance - - - Household Savings, Borrowing, Debt, and Wealth
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I32 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Measurement and Analysis of Poverty

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