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. 2017 Feb 6:10.1007/s10754-017-9211-2.
doi: 10.1007/s10754-017-9211-2. Online ahead of print.

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

Tianyan Hu  1 , Sandra L Decker  2 , Shin-Yi Chou  3
Affiliations

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

Tianyan Hu et al. Int J Health Econ Manag. .

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.

Keywords: Expenditure of health care; Medicare; Part D; Prescribing pattern; Prescription drug.

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Figures

Figure 1:
Figure 1:. Number of Drugs Prescribed of Continued During a Physician Visit, NAMCS 2002–2004 and 2006–2009
Note: Samples are based on data from the National Ambulatory Medical Care Survey (2002–2004 and 2005–2009). The estimated discontinuities (and standard errors) at age 65 and the fitted lines are from a regression with a cubic polynomial in age fully interacted with a dummy for age greater than or equal to 65 and a dummy for year in or after 2006. Points represent means for people in each age cell (measured in quarters).
Figure 2:
Figure 2:. Number of Drugs with A Generic Equivalent Prescribed or Continued During a Physician Visit, NAMCS 2002–2004 and 2006–2009
Note: Samples are based on data from the National Ambulatory Medical Care Survey (2002–2004 and 2005–2009). The estimated discontinuities (and standard errors) at age 65 and the fitted lines are from a regression with a cubic polynomial in age fully interacted with a dummy for age greater than or equal to 65 and a dummy for year in or after 2006. Points represent means for people in each age cell (measured in quarters).
Figure 3:
Figure 3:. Distribution of Patient Age at Physician Visits, NAMCS 2002–2004 and 2006–2009
Note: Samples are based on data from the National Ambulatory Medical Care Survey (2002–2004 and 2005–2009). The estimated discontinuities (and standard errors) at age 65 and the fitted lines are from a regression with a cubic polynomial in age fully interacted with a dummy for age greater than or equal to 65 and a dummy for year in or after 2006. Points represent means for people in each age cell (measured in quarters).
See this image and copyright information in PMC

References

    1. Acemoglu D & Finkelstein A, 2008. Input and Technology Choices in Regulated Industries: Evidence from the Health Care Sector. Journal of Political Economy, 116(5), pp.837–880.
    1. Alexander GC, Casalino LP & Meltzer DO, 2003. Patient-physician communication about out-of-pocket costs. JAMA : the journal of the American Medical Association, 290(7), pp.953–8. - PubMed
    1. Alpert A, 2012. The Anticipatory Effects of Medicare Part D on Drug Utilization. SSRN Electronic Journal. - PMC - PubMed
    1. Anderson ML, Dobkin C & Gross T, 2014. The Effect of Health Insurance on Emergency Department Visits: Evidence from an Age-Based Eligibility Threshold. Review of Economics and Statistics, 96(1), pp.189–195.
    1. Arrow KJ, 1963. Uncertainty and the Welfare Economics of Medical Care. The American Economic Review, 53(5), pp.941–973.

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