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The impact of health insurance expansion on physician treatment choice: Medicare Part D and physician prescribing

Author

Listed:
  • Tianyan Hu

    (Florida International University)

  • Sandra L. Decker

    (Agency for Healthcare Research and Quality (AHRQ))

  • Shin-Yi Chou

    (Lehigh University)

Abstract

We test the effect of the introduction of Medicare Part D on physician prescribing behavior by using data on physician visits from the National Ambulatory Medical Care Survey (NAMCS) 2002–2004 and 2006–2009 for patients aged 60–69. We use regression discontinuity designs to estimate the effect of part D around the age of 65 before and after 2006 and then compare the discrete jump in outcomes at age 65 before and after Part D. We find a 32% increase in the number of prescription drugs prescribed or continued per visit and a 46% increase in the number of generic drugs prescribed or continued for the elderly after the introduction of Medicare Part D.

Suggested Citation

  • Tianyan Hu & Sandra L. Decker & Shin-Yi Chou, 2017. "The impact of health insurance expansion on physician treatment choice: Medicare Part D and physician prescribing," International Journal of Health Economics and Management, Springer, vol. 17(3), pages 333-358, September.
    • Handle: RePEc:kap:ijhcfe:v:17:y:2017:i:3:d:10.1007_s10754-017-9211-2
    DOI: 10.1007/s10754-017-9211-2
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    1. Chalkley, Martin & Malcomson, James M., 1998. "Contracting for health services when patient demand does not reflect quality," Journal of Health Economics, Elsevier, vol. 17(1), pages 1-19, January.
    2. Mark Duggan & Fiona Scott Morton, 2010. "The Effect of Medicare Part D on Pharmaceutical Prices and Utilization," American Economic Review, American Economic Association, vol. 100(1), pages 590-607, March.
    3. Gary V. Engelhardt & Jonathan Gruber, 2011. "Medicare Part D and the Financial Protection of the Elderly," American Economic Journal: Economic Policy, American Economic Association, vol. 3(4), pages 77-102, November.
    4. David S. Lee & Thomas Lemieux, 2010. "Regression Discontinuity Designs in Economics," Journal of Economic Literature, American Economic Association, vol. 48(2), pages 281-355, June.
    5. Imbens, Guido W. & Lemieux, Thomas, 2008. "Regression discontinuity designs: A guide to practice," Journal of Econometrics, Elsevier, vol. 142(2), pages 615-635, February.
    6. David Card & Carlos Dobkin & Nicole Maestas, 2009. "Does Medicare Save Lives?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 124(2), pages 597-636.
    7. McGuire, Thomas G., 2000. "Physician agency," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 9, pages 461-536, Elsevier.
    8. McCrary, Justin, 2008. "Manipulation of the running variable in the regression discontinuity design: A density test," Journal of Econometrics, Elsevier, vol. 142(2), pages 698-714, February.
    9. Mark G. Duggan & Fiona Scott Morton, 2011. "The Medium-Term Impact of Medicare Part D on Pharmaceutical Prices," American Economic Review, American Economic Association, vol. 101(3), pages 387-392, May.
    10. Robert Kaestner & Nasreen Khan, 2012. "Medicare Part D and Its Effect on the Use of Prescription Drugs and Use of Other Health Care Services of the Elderly," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 31(2), pages 253-279, March.
    11. Lakdawalla, Darius & Sood, Neeraj & Gu, Qian, 2013. "Pharmaceutical advertising and Medicare Part D," Journal of Health Economics, Elsevier, vol. 32(6), pages 1356-1367.
    12. Robert Kaestner & Cuping Schiman & G. Caleb Alexander, 2019. "Effects of Prescription Drug Insurance on Hospitalization and Mortality: Evidence from Medicare Part D," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 86(3), pages 595-628, September.
    13. Andrew J. Epstein & Jonathan D. Ketcham, 2014. "Information technology and agency in physicians' prescribing decisions," RAND Journal of Economics, RAND Corporation, vol. 45(2), pages 422-448, June.
    14. Blume-Kohout, Margaret E. & Sood, Neeraj, 2013. "Market size and innovation: Effects of Medicare Part D on pharmaceutical research and development," Journal of Public Economics, Elsevier, vol. 97(C), pages 327-336.
    15. Ellis, Randall P. & McGuire, Thomas G., 1986. "Provider behavior under prospective reimbursement : Cost sharing and supply," Journal of Health Economics, Elsevier, vol. 5(2), pages 129-151, June.
    16. Veronica Grembi & Tommaso Nannicini & Ugo Troiano, 2016. "Do Fiscal Rules Matter?," American Economic Journal: Applied Economics, American Economic Association, vol. 8(3), pages 1-30, July.
    17. Feldstein, Martin S, 1970. "The Rising Price of Physicians' Services," The Review of Economics and Statistics, MIT Press, vol. 52(2), pages 121-133, May.
    18. Weisbrod, Burton A, 1991. "The Health Care Quadrilemma: An Essay on Technological Change, Insurance, Quality of Care, and Cost Containment," Journal of Economic Literature, American Economic Association, vol. 29(2), pages 523-552, June.
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    Cited by:

    1. Thomas M. Selden & Zeynal Karaca & Sandra Decker, 2018. "Has inpatient hospital treatment before and after age 65 changed as the difference between private and Medicare payment rates has widened?," International Journal of Health Economics and Management, Springer, vol. 18(4), pages 409-423, December.
    2. Matthew T. Knowles, 2022. "How access to addictive drugs affects the supply of substance abuse treatment: Evidence from Medicare Part D," Health Economics, John Wiley & Sons, Ltd., vol. 31(8), pages 1649-1675, August.
    3. Donghoon Lee & SangJune Kim & Jerome A. Dugan, 2024. "The effect of prescription drug insurance on the incidence of potentially inappropriate prescribing: Evidence from Medicare Part D," Health Economics, John Wiley & Sons, Ltd., vol. 33(1), pages 137-152, January.
    4. Ge Ge & Geir Godager & Jian Wang, 2022. "Exploring physician agency under demand‐side cost sharing—An experimental approach," Health Economics, John Wiley & Sons, Ltd., vol. 31(6), pages 1202-1227, June.
    5. Aslim, Erkmen Giray, 2022. "Public health insurance and employment transitions," Labour Economics, Elsevier, vol. 75(C).
    6. Abraham Abebe Asfaw, 2019. "The effect of prescription drug insurance on health behavior: Evidence from Medicare Part D," Health Economics, John Wiley & Sons, Ltd., vol. 28(3), pages 403-418, March.
    7. Adolf Kwadzo Dzampe & Shingo Takahashi, 2022. "Competition and physician-induced demand in a healthcare market with regulated price: evidence from Ghana," International Journal of Health Economics and Management, Springer, vol. 22(3), pages 295-313, September.
    8. DiNardi, Michael, 2021. "Aging out of the federal dependent coverage mandate and purchases of prescription drugs with high rates of misuse," Economics & Human Biology, Elsevier, vol. 43(C).
    9. Bocong Yuan & Jiannan Li, 2019. "The Policy Effect of the General Data Protection Regulation (GDPR) on the Digital Public Health Sector in the European Union: An Empirical Investigation," IJERPH, MDPI, vol. 16(6), pages 1-15, March.

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    More about this item

    Keywords

    Medicare; Part D; Prescription drug; Expenditure of health care; Prescribing pattern;
    All these keywords.

    JEL classification:

    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I31 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - General Welfare, Well-Being

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