| 来源类型 | Working Paper |
| 规范类型 | 报告 |
| DOI | 10.3386/w27223 |
| 来源ID | Working Paper 27223 |
| Voluntary Regulation: Evidence from Medicare Payment Reform | |
| Liran Einav; Amy Finkelstein; Yunan Ji; Neale Mahoney | |
| 发表日期 | 2020-05-25 |
| 出版年 | 2020 |
| 语种 | 英语 |
| 摘要 | Government programs are often offered on an optional basis to market participants. We explore the economics of such voluntary regulation in the context of a Medicare payment reform, in which one medical provider receives a single, predetermined payment for a sequence of related healthcare services, instead of separate service-specific payments. This “bundled payment” program was originally implemented as a 5-year randomized trial, with mandatory participation by hospitals assigned to the new payment model, but after two years participation was unexpectedly made voluntary for half of these hospitals. Using detailed claim-level data, we document that voluntary participation is more likely for hospitals who can increase revenue without changing behavior (“selection on levels”) and for hospitals that had large changes in behavior when participation was mandatory (“selection on slopes”). To assess outcomes under counterfactual regimes, we estimate a simple model of responsiveness to and selection into the program. We find that the current voluntary regime generates inefficient transfers to hospitals and reduces social welfare compared to the status quo, but that alternative (feasible) designs could substantially reduce these inefficient transfers. Our analysis highlights key design elements to consider under voluntary regulation. |
| 主题 | Public Economics ; National Fiscal Issues ; Health, Education, and Welfare ; Health |
| URL | https://www.nber.org/papers/w27223 |
| 来源智库 | National Bureau of Economic Research (United States) |
| 引用统计 | |
| 资源类型 | 智库出版物 |
| 条目标识符 | http://119.78.100.153/handle/2XGU8XDN/584895 |
| 推荐引用方式 GB/T 7714 | Liran Einav,Amy Finkelstein,Yunan Ji,et al. Voluntary Regulation: Evidence from Medicare Payment Reform. 2020. |
| 条目包含的文件 | ||||||
| 文件名称/大小 | 资源类型 | 版本类型 | 开放类型 | 使用许可 | ||
| w27223.pdf（728KB） | 智库出版物 | 限制开放 | CC BY-NC-SA | 浏览 | ||
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