WORKING PAPERS
"Does Reimbursement Matter? Evaluating Medicare Advantage Plan Availability and Penetration"
Abstract: For many seniors, Medicare Advantage (MA) plans offer more financial and healthcare benefits. A key aspect determining the affordability and availability of these plans is the government subsidies via supply-side reimbursements. Under the current mechanism, the Centers for Medicare and Medicaid Services (CMS) rank counties based on their traditional fee-for-service (FFS) spending, divide them into quartiles, and set annual cap payments, known as benchmarks, based on the quartile. Using data from CMS and a regression discontinuity design, I leverage the discontinuous jumps in these benchmarks and compare changes in the market structure and penetration for counties surrounding the quartile cutoffs. Overall, I find insignificant estimates for the number of operating firms, the number of plans available, or penetration. These findings are suggestive that firms and MA plans are insensitive to these payment differences along the margins. These results have important policy implications in the wake of debates on overpayments. Lastly, I analyze different reimbursement designs using the Marginal Value of Public Funds (MVPF) framework. MVPF serves a dual role: First, it measures the welfare impact of the current payment system per dollar increase in public costs. Second, it provides a valuable metric for understanding the inherent value of each payment arrangement, which is fundamental for comparative analysis. When deciding whether and how to adjust Medicare payments to private plans, policymakers should reconsider the program's goals and take measures to achieve efficiencies while preserving access and quality of care for beneficiaries.
Recognition: Timothy Gunning Award for Best Third-Year Economics Paper.
Presented at (including scheduled): American Society of Health Economists Annual Conference, Association for Public Policy Analysis & Management Annual Fall Research Conference.
"Which Medical Prices are Driving Health Insurance Premium Growth?," with Vivian Ho. Revised & Resubmitted to JAMA Open Network.
"Ripple Effects: How Neighboring Hospital Changes Impact Profitability Metrics," with Shishir Shakya. Under Review.
Presented at (including scheduled): Association for Public Policy Analysis & Management Annual Fall Research Conference, Southern Economic Association Annual Meeting.
"Childcare Arrangements, Priorities, and Employment Impacts Among Healthcare Professionals," with Christopher Kulesza, Katarina Reyes, Nelly Akhmadikina, and Sandra McKay. Under Review.
"The Impact of ACA Medicaid Expansion on Appointment Wait Time in Community Health Centers," with David Anderson, Sukriti Beniwal, and Shishir Shakya. Submitted.
Presented at: American Society of Health Economists Annual Conference.
