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How managed care affects medicaid utilization a synthetic difference-in-differences zero-inflated count model

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Author Info
Freund, D.A.
Kniesner, T.J.
LoSasso, A.T. (Tilburg University, Center for Economic Research)

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Abstract

We develop a synthetic difference-in-differences statistical design to apply to experimental data for adult women living in Hennepin County, Minnesota, to estimate the impact of Medicaid managed care on various modes of medical care use. Because the outcomes of interest are utilization counts with many persons using none of a particular mode of care we use count regression models that are adjusted for excessive zeros. We find no reductions in physician visits or hospital inpatient and emergency department care use, but reductions in hospital outpatient care. Simulations designed to judge the economic significance of our results suggest a program effect that is a savings of about ten percent.

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Publisher Info
Paper provided by Tilburg University, Center for Economic Research in its series Discussion Paper with number 40.

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Date of creation: 1996
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Handle: RePEc:dgr:kubcen:199640

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Find related papers by JEL classification:
I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
C25 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Discrete Regression and Qualitative Choice Models
C23 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Models with Panel Data

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  1. Leibowitz, Arleen & Buchanan, Joan L. & Mann, Joyce, 1992. "A randomized trial to evaluate the effectiveness of a Medicaid HMO," Journal of Health Economics, Elsevier, vol. 11(3), pages 235-257, October. [Downloadable!] (restricted)
  2. Heckman, James J & Smith, Jeffrey A, 1995. "Assessing the Case for Social Experiments," Journal of Economic Perspectives, American Economic Association, vol. 9(2), pages 85-110, Spring. [Downloadable!] (restricted)
  3. James J. Heckman, 1995. "Instrumental Variables: A Cautionary Tale," NBER Technical Working Papers 0185, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  4. repec:att:wimass:199217 is not listed on IDEAS
  5. Vuong, Quang H, 1989. "Likelihood Ratio Tests for Model Selection and Non-nested Hypotheses," Econometrica, Econometric Society, vol. 57(2), pages 307-33, March. [Downloadable!] (restricted)
  6. William H. Greene, 1994. "Accounting for Excess Zeros and Sample Selection in Poisson and Negative Binomial Regression Models," Working Papers 94-10, New York University, Leonard N. Stern School of Business, Department of Economics.
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Cited by:
(explanations, Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.)

  1. Robert Kaestner & Lisa Dubay & Genevieve Kenney, 2002. "Medicaid Managed Care and Infant Health: A National Evaluation," NBER Working Papers 8936, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
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