Journal
PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA
Volume 117, Issue 32, Pages 18939-18947Publisher
NATL ACAD SCIENCES
DOI: 10.1073/pnas.2004759117
Keywords
bundled payments; healthcare; randomized controlled trial; spillover
Categories
Funding
- J-PAL North America's Health Care Delivery Initiative
- National Institute of Aging [P01AG019783-15]
- Laura and John Arnold Foundation
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Changes in the way health insurers pay healthcare providers may not only directly affect the insurer's patients but may also affect patients covered by other insurers. We provide evidence of such spillovers in the context of a nationwide Medicare bundled payment reform that was implemented in some areas of the country but not in others, via random assignment. We estimate that the payment reform-which targeted traditional Medicare patients-had effects of similar magnitude on the healthcare experience of nontargeted, privately insured Medicare Advantage patients. We discuss the implications of these findings for estimates of the impact of healthcare payment reforms and more generally for the design of healthcare policy.
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