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The effects of medicare advantage on opioid use

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  • Baker, Laurence C.
  • Bundorf, M. Kate
  • Kessler, Daniel P.

Abstract

Despite a vast literature on the determinants of prescription opioid use, the role of health insurance plans has received little attention. We study how the form of Medicare beneficiaries’ drug coverage affects the volume of opioids they consume. We find that enrollment in Medicare Advantage, which integrates drug coverage with other medical benefits, significantly reduces beneficiaries’ likelihood of filling an opioid prescription, as compared to enrollment in a stand-alone drug plan. Approximately half of this effect was due to fewer fills from prescribers who write a very large number of opioid prescriptions.

Suggested Citation

  • Baker, Laurence C. & Bundorf, M. Kate & Kessler, Daniel P., 2020. "The effects of medicare advantage on opioid use," Journal of Health Economics, Elsevier, vol. 70(C).
  • Handle: RePEc:eee:jhecon:v:70:y:2020:i:c:s0167629619304758
    DOI: 10.1016/j.jhealeco.2019.102278
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    References listed on IDEAS

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    1. Christopher C. Afendulis & Michael E. Chernew & Daniel P. Kessler, 2017. "The Effect of Medicare Advantage on Hospital Admissions and Mortality," American Journal of Health Economics, University of Chicago Press, vol. 3(2), pages 254-279, Spring.
    2. Molly Schnell & Janet Currie, 2018. "Addressing the Opioid Epidemic: Is There a Role for Physician Education?," American Journal of Health Economics, MIT Press, vol. 4(3), pages 383-410, Summer.
    3. Chernew, Michael & DeCicca, Philip & Town, Robert, 2008. "Managed care and medical expenditures of Medicare beneficiaries," Journal of Health Economics, Elsevier, vol. 27(6), pages 1451-1461, December.
    4. Duggan, Mark & Starc, Amanda & Vabson, Boris, 2016. "Who benefits when the government pays more? Pass-through in the Medicare Advantage program," Journal of Public Economics, Elsevier, vol. 141(C), pages 50-67.
    5. Baker, Laurence C., 1997. "The effect of HMOs on fee-for-service health care expenditures: Evidence from Medicare," Journal of Health Economics, Elsevier, vol. 16(4), pages 453-481, August.
    6. Marika Cabral & Michael Geruso & Neale Mahoney, 2018. "Do Larger Health Insurance Subsidies Benefit Patients or Producers? Evidence from Medicare Advantage," American Economic Review, American Economic Association, vol. 108(8), pages 2048-2087, August.
    7. Powell, David & Pacula, Rosalie Liccardo & Taylor, Erin, 2020. "How increasing medical access to opioids contributes to the opioid epidemic: Evidence from Medicare Part D," Journal of Health Economics, Elsevier, vol. 71(C).
    8. Christopher C. Afendulis & Michael E. Chernew & Daniel P. Kessler, 2017. "The Effect of Medicare Advantage on Hospital Admissions and Mortality," American Journal of Health Economics, MIT Press, vol. 3(2), pages 254-279, Spring.
    9. Dasgupta, N. & Beletsky, L. & Ciccarone, D., 2018. "Opioid Crisis: No Easy Fix to Its Social and Economic Determinants," American Journal of Public Health, American Public Health Association, vol. 108(2), pages 182-186.
    10. Thomas C. Buchmueller & Colleen Carey, 2018. "The Effect of Prescription Drug Monitoring Programs on Opioid Utilization in Medicare," American Economic Journal: Economic Policy, American Economic Association, vol. 10(1), pages 77-112, February.
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    Keywords

    Medicare advantage; Opioid use;

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