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Changing Mix of Medical Care Services: Stylized Facts and Implications for Price Indexes

Author

Listed:
  • Ana Aizcorbe
  • Nicole Nestoriak

    (Bureau of Economic Analysis)

Abstract

The utilization of health care services has undergone several important shifts in recent years that have implications for the cost of medical care. We empirically document the presence of these shifts for a broad list of medical conditions and assess the implications for price indexes. Following the earlier literature, we compare the growth of two price measures: one that tracks expenditures for the services actually provided to treat conditions and another that holds the mix of those services fixed over time. Using retrospective claims data for a sample of commercially-insured patients, we find that, on average, expenditures to treat diseases rose 11% from 2003:1 to 2005:4 and would have risen even faster, 18%, had the mix of services remained fixed at the 2003:1 levels. This suggests that fixed-basket price indexes, as are used in the official statistics, could overstate true price growth significantly.

Suggested Citation

  • Ana Aizcorbe & Nicole Nestoriak, 2010. "Changing Mix of Medical Care Services: Stylized Facts and Implications for Price Indexes," BEA Working Papers 0064, Bureau of Economic Analysis.
  • Handle: RePEc:bea:wpaper:0064
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    1. David M. Cutler & Mark B. McClellan & Joseph P. Newhouse & Dahlia K. Remler, 2001. "Pricing Heart Attack Treatments," NBER Chapters, in: Medical Care Output and Productivity, pages 305-362, National Bureau of Economic Research, Inc.
    2. Ernst R. Berndt & David M. Cutler & Richard Frank & Zvi Griliches & Joseph P. Newhouse & Jack E. Triplett, 2001. "Price Indexes for Medical Care Goods and Services -- An Overview of Measurement Issues," NBER Chapters, in: Medical Care Output and Productivity, pages 141-200, National Bureau of Economic Research, Inc.
    3. Duggan, Mark, 2005. "Do new prescription drugs pay for themselves?: The case of second-generation antipsychotics," Journal of Health Economics, Elsevier, vol. 24(1), pages 1-31, January.
    4. David M. Cutler & Mark McClellan & Joseph P. Newhouse & Dahlia Remler, 1998. "Are Medical Prices Declining? Evidence from Heart Attack Treatments," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 113(4), pages 991-1024.
    5. Ana Aizcorbe & Eli Liebman & Sarah Pack & David M. Cutler & Michael E. Chernew & Allison B. Rosen, 2010. "Measuring Health Care Costs of Individuals with Employer-Sponsored Health Insurance in the U.S.: A Comparison of Survey and Claims Data," BEA Working Papers 0066, Bureau of Economic Analysis.
    6. David M. Cutler & Ernst R. Berndt, 2001. "Medical Care Output and Productivity," NBER Books, National Bureau of Economic Research, Inc, number cutl01-1, March.
    7. F. M. Fisher & K. Shell, 1970. "The Pure Theory of the National-Output Deflator," Working papers 59, Massachusetts Institute of Technology (MIT), Department of Economics.
    8. Gregory S. Crawford & Matthew Shum, 2005. "Uncertainty and Learning in Pharmaceutical Demand," Econometrica, Econometric Society, vol. 73(4), pages 1137-1173, July.
    9. Berndt, Ernst R. & Cutler, David M. & Frank, Richard G. & Griliches, Zvi & Newhouse, Joseph P. & Triplett, Jack E., 2000. "Medical care prices and output," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 3, pages 119-180, Elsevier.
    10. Richard G. Frank & Thomas G. McGuire & Sharon-Lise Normand, 2006. "Cost-Offsets of New Medications for Treatment of Schizophrenia," NBER Working Papers 12643, National Bureau of Economic Research, Inc.
    11. Berndt Ernst R. & Busch Alisa B. & Frank Richard G. & Normand Sharon-Lise, 2006. "Real Output in Mental Health Care during the 1990s," Forum for Health Economics & Policy, De Gruyter, vol. 9(1), pages 1-19, December.
    12. Irving Shapiro & Matthew D. Shapiro & David Wilcox, 2001. "Measuring the value of Cataract Surgery," NBER Chapters, in: Medical Care Output and Productivity, pages 411-438, National Bureau of Economic Research, Inc.
    13. Xue Song & William D. Marder & Robert Houchens & Jonathan E. Conklin & Ralph Bradley, 2009. "Can A Disease-Based Price Index Improve the Estimation of the Medical Consumer Price Index?," NBER Chapters, in: Price Index Concepts and Measurement, pages 329-368, National Bureau of Economic Research, Inc.
    14. Joseph P. Newhouse, 1992. "Medical Care Costs: How Much Welfare Loss?," Journal of Economic Perspectives, American Economic Association, vol. 6(3), pages 3-21, Summer.
    15. Ernst R. Berndt & Alisa B. Busch & Richard G. Frank & Sharon-Lise Normand, 2006. "Real Output in Mental Health Care during the 1990s," NBER Chapters, in: Frontiers in Health Policy Research, Volume 9, National Bureau of Economic Research, Inc.
    16. A. J. Culyer & J. P. Newhouse (ed.), 2000. "Handbook of Health Economics," Handbook of Health Economics, Elsevier, edition 1, volume 1, number 1.
    17. Ernst R. Berndt & Susan Busch & Richard Frank, 2001. "Treatment Price Indexes for Acute Phase Major Depression," NBER Chapters, in: Medical Care Output and Productivity, pages 463-508, National Bureau of Economic Research, Inc.
    18. Frank, Richard G. & Berndt, Ernst R. & Busch, Alisa B. & Lehman, Anthony F., 2004. "Quality-constant "prices" for the ongoing treatment of schizophrenia: an exploratory study," The Quarterly Review of Economics and Finance, Elsevier, vol. 44(3), pages 390-409, July.
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    JEL classification:

    • E6 - Macroeconomics and Monetary Economics - - Macroeconomic Policy, Macroeconomic Aspects of Public Finance, and General Outlook

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