Incentives and Selection Effects of Drug Coverage on Total Drug Expenditure: a Finite Mixture Approach
This paper takes a nte mixture approach to model heterogeneity in incentives and selection effects of drug coverage on the total drug expenditure among the Medicare elderly US population. Evidence is found that the positive drug expenditures of the entire elderly popultion can be decomposed into two groups of relatively healthy with lower average expenditures and relatively unhealthy with higher average expenditures, accounting for approaximately 25% and 75% of the population, respectively. The incentive effects of drug insurance, i.e. ex post moral hazard, are much stronger in magnitude for the unhealthy group. There is also evidence of adverse selection into drug insurance, and this appears to be greater for the higher-expenditure component.
|Date of creation:||Jul 2009|
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- Fruhwirth-Schnatter S., 2001. "Markov Chain Monte Carlo Estimation of Classical and Dynamic Switching and Mixture Models," Journal of the American Statistical Association, American Statistical Association, vol. 96, pages 194-209, March.
- Goldman, Dana P. & Hosek, Susan D. & Dixon, Lloyd S. & Sloss, Elizabeth M., 1995. "The effects of benefit design and managed care on health care costs," Journal of Health Economics, Elsevier, vol. 14(4), pages 401-418, October.
- Duan, Naihua, et al, 1983. "A Comparison of Alternative Models for the Demand for Medical Care," Journal of Business & Economic Statistics, American Statistical Association, vol. 1(2), pages 115-26, April.
- Teresa Bago d'Uva, 2006.
"Latent class models for utilisation of health care,"
John Wiley & Sons, Ltd., vol. 15(4), pages 329-343.
- Teresa Bago d’Uva, 2005. "Latent class models for utilisation of health care," Health, Econometrics and Data Group (HEDG) Working Papers 05/01, HEDG, c/o Department of Economics, University of York.
- John Geweke & Gautam Gowrisankaran & Robert J. Town, 2003.
"Bayesian Inference for Hospital Quality in a Selection Model,"
Econometric Society, vol. 71(4), pages 1215-1238, 07.
- John Geweke & Gautam Gowrisankaran & Robert J. Town, 2001. "Bayesian Inference for Hospital Quality in a Selection Model," NBER Working Papers 8497, National Bureau of Economic Research, Inc.
- John F. Geweke & Gautam Gowrisankaran & Robert J. Town, 2002. "Bayesian inference for hospital quality in a selection model," Working Paper Series 2002-18, Federal Reserve Bank of San Francisco.
- Lee A. Lillard & Jeannette Rogowski & Raynard Kington, 1999.
"Insurance Coverage for Prescription Drugs: Effects on Use and Expenditures in the Medicare Population,"
99-09, RAND Corporation.
- Lillard, L.A. & Rogowski, J. & Kington, R., 1999. "Insurance Coverage for Prescription Drugs: Effects on Use and Expenditures in the Medicare Population," Papers 99-09, RAND - Labor and Population Program.
- Willard G. Manning & John Mullahy, 1999.
"Estimating Log Models: To Transform or Not to Transform?,"
NBER Technical Working Papers
0246, National Bureau of Economic Research, Inc.
- Manning, Willard G. & Mullahy, John, 2001. "Estimating log models: to transform or not to transform?," Journal of Health Economics, Elsevier, vol. 20(4), pages 461-494, July.
- Goldman Dana P & Joyce Geoffrey & Karaca-Mandic Pinar & Sood Neeraj, 2006.
"Adverse Selection in Retiree Prescription Drug Plans,"
Forum for Health Economics & Policy,
De Gruyter, vol. 9(1), pages 1-25, December.
- Dana P. Goldman & Geoffrey Joyce & Pinar Karaca-Mandic, 2006. "Adverse Selection in Retiree Prescription Drug Plans," NBER Chapters, in: Frontiers in Health Policy Research, Volume 9 National Bureau of Economic Research, Inc.
- Partha Deb & Karen Smith Conway, 2002.
"Is Prenatal Care Really Ineffective? Or, is the 'Devil' in the Distribution?,"
Economics Working Paper Archive at Hunter College
02/2, Hunter College Department of Economics.
- Conway, Karen Smith & Deb, Partha, 2005. "Is prenatal care really ineffective? Or, is the 'devil' in the distribution?," Journal of Health Economics, Elsevier, vol. 24(3), pages 489-513, May.
- Dana Goldman & Tomas Philipson, 2007.
"Integrated Insurance Design in the Presence of Multiple Medical Technologies,"
NBER Working Papers
12870, National Bureau of Economic Research, Inc.
- Tomas J. Philipson & Dana Goldman, 2007. "Integrated Insurance Design in the Presence of Multiple Medical Technologies," American Economic Review, American Economic Association, vol. 97(2), pages 427-432, May.
- Geweke, John & Keane, Michael, 2007. "Smoothly mixing regressions," Journal of Econometrics, Elsevier, vol. 138(1), pages 252-290, May.
- Teresa Bago d'Uva, 2005. "Latent class models for use of primary care: evidence from a British panel," Health Economics, John Wiley & Sons, Ltd., vol. 14(9), pages 873-892.
- Mullahy, John, 1998. "Much ado about two: reconsidering retransformation and the two-part model in health econometrics," Journal of Health Economics, Elsevier, vol. 17(3), pages 247-281, June.
- Nasreen Khan & Robert Kaestner & Swu Jane Lin, 2007. "Prescription Drug Insurance and Its Effect on Utilization and Health of the Elderly," NBER Working Papers 12848, National Bureau of Economic Research, Inc.
- Keane, Michael P, 1992. "A Note on Identification in the Multinomial Probit Model," Journal of Business & Economic Statistics, American Statistical Association, vol. 10(2), pages 193-200, April.
- Murat K. Munkin & Partha Deb & Pravin K. Trivedi, 2006. "Bayesian analysis of the two-part model with endogeneity: application to health care expenditure," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 21(7), pages 1081-1099.
- Willard G. Manning Jr. & Charles E. Phelps, 1979. "The Demand for Dental Care," Bell Journal of Economics, The RAND Corporation, vol. 10(2), pages 503-525, Autumn.
- Jones, Andrew M., 2000.
Handbook of Health Economics,
in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 6, pages 265-344
- Baoping Shang & Dana P. Goldman, 2007. "Prescription Drug Coverage and Elderly Medicare Spending," NBER Working Papers 13358, National Bureau of Economic Research, Inc.
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