价格定对了吗？医疗保险计划中竞争性招标的影响
Getting the Price Right? The Impact of Competitive Bidding in the Medicare Program
Review of Economics and Statistics · 2022 · [{"name": "Hui Ding", "affiliation": ["Princeton University", "Fudan University"]}, {"name": "Mark Duggan", "affiliation": ["Stanford University"]}, {"name": "Amanda Starc", "affiliation": ["Northwestern University", "Northwestern University"]}]
中文摘要
我们研究医疗保险计划针对耐用医疗设备实施的竞争性招标项目。我们利用医疗保险理赔数据考察该项目对价格和使用量的影响，重点关注用于睡眠呼吸暂停的持续气道正压通气设备。我们发现，在引入一种高度不完善的招标机制后，支出下降了47.2%。这几乎完全由价格下降44.8%所驱动，尽管数量也下降了4.3%。为区分供给与需求，我们利用了医疗保险受益人之间费用分担的差异。我们测得需求弹性为-0.272，并发现数量降幅集中在临床适用性较低的群体中。
Abstract
Abstract We study Medicare’s competitive bidding program for durable medical equipment. We use Medicare claims data to examine the effect on prices and utilization, focusing on continuous positive airway pressure devices for sleep apnea. We find that spending falls by 47.2% after a highly imperfect bidding mechanism is introduced. This is almost entirely driven by a 44.8% price reduction, though quantities also fall by 4.3%. To disentangle supply and demand, we leverage differential cost sharing across Medicare recipients. We measure a demand elasticity of -0.272 and find that quantity reductions are concentrated among less clinically appropriate groups.