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Geographic Variation in Commercial Medical Care Expenditures: A Decomposition Between Price and Utilization

Author

Listed:
  • Abe C. Dunn
  • Adam Shapiro
  • Eli Liebman

    (Bureau of Economic Analysis)

Abstract

This study examines geographic variation in commercial medical care expenditures. Medical care expenditures are decomposed between service prices and service utilization. We find that both service prices and utilization contribute to overall differences in health spending across geographic markets. Our findings suggest that potential expenditure savings may be possible from more efficient utilization. However, the large variation in underlying service prices suggests that deviations in overall spending may persist, even if utilization differences across markets are diminished.

Suggested Citation

  • Abe C. Dunn & Adam Shapiro & Eli Liebman, 2011. "Geographic Variation in Commercial Medical Care Expenditures: A Decomposition Between Price and Utilization," BEA Working Papers 0075, Bureau of Economic Analysis.
    • Handle: RePEc:bea:wpaper:0075
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    References listed on IDEAS

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    1. Amitabh Chandra & Douglas O. Staiger, 2007. "Productivity Spillovers in Health Care: Evidence from the Treatment of Heart Attacks," Journal of Political Economy, University of Chicago Press, vol. 115(1), pages 103-140.
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    3. Phelps, Charles E., 1995. "Welfare loss from variations: further considerations," Journal of Health Economics, Elsevier, vol. 14(2), pages 253-260, June.
    4. Charles E. Phelps, 1997. "Good Technologies Gone Bad," Medical Decision Making, , vol. 17(1), pages 107-117, February.
    5. Aizcorbe, Ana & Nestoriak, Nicole, 2011. "Changing mix of medical care services: Stylized facts and implications for price indexes," Journal of Health Economics, Elsevier, vol. 30(3), pages 568-574, May.
    6. Amitabh Chandra & Douglas Staiger, 2004. "Testing a Roy Model with Productivity Spillovers: Evidence from the Treatment of Heart Attacks," NBER Working Papers 10811, National Bureau of Economic Research, Inc.
    7. Abe Dunn & Adam Hale Shapiro, 2011. "Physician Market Power and Medical-Care Expenditures," BEA Working Papers 0078, Bureau of Economic Analysis.
    8. A. J. Culyer & J. P. Newhouse (ed.), 2000. "Handbook of Health Economics," Handbook of Health Economics, Elsevier, edition 1, volume 1, number 1.
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    Cited by:

    1. Abe Dunn & Eli Liebman & Adam Hale Shapiro, 2016. "Decomposing Medical Care Expenditure Growth," NBER Chapters, in: Measuring and Modeling Health Care Costs, pages 81-111, National Bureau of Economic Research, Inc.
    2. Dunn, Abe, 2016. "Health insurance and the demand for medical care: Instrumental variable estimates using health insurer claims data," Journal of Health Economics, Elsevier, vol. 48(C), pages 74-88.
    3. Eibich, Peter & Ziebarth, Nicolas R., 2014. "Analyzing regional variation in health care utilization using (rich) household microdata," Health Policy, Elsevier, vol. 114(1), pages 41-53.
    4. Anne E. Hall, 2015. "Regional Patterns in Medical Technology Utilization," BEA Working Papers 0126, Bureau of Economic Analysis.
    5. Abe Dunn & Eli Liebman & Adam Hale Shapiro, 2014. "Developing a Framework for Decomposing Medical-Care Expenditure Growth: Exploring Issues of Representativeness," NBER Chapters, in: Measuring Economic Sustainability and Progress, pages 545-574, National Bureau of Economic Research, Inc.
    6. Abe Dunn & Adam Hale Shapiro, 2011. "Physician Market Power and Medical-Care Expenditures," BEA Working Papers 0078, Bureau of Economic Analysis.
    7. Dunn, Abe & Shapiro, Adam Hale, 2015. "Physician payments under health care reform," Journal of Health Economics, Elsevier, vol. 39(C), pages 89-105.
    8. Amy Finkelstein & Matthew Gentzkow & Heidi Williams, 2016. "Sources of Geographic Variation in Health Care: Evidence From PatientMigration," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 131(4), pages 1681-1726.

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    JEL classification:

    • E6 - Macroeconomics and Monetary Economics - - Macroeconomic Policy, Macroeconomic Aspects of Public Finance, and General Outlook

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