Evidence map›Paper›PMID 38944945›Full record

ArticleJournal of health economics2024

Adverse selection and network design under regulated plan prices: Evidence from Medicaid.

Amanda R Kreider, Timothy J Layton, Mark Shepard, Jacob Wallace

Abstract read
In one paragraph

Article in Journal of health economics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Amanda R KreiderUniversity of Pennsylvania, United States of America. Electronic address: akreid@wharton.upenn.edu.
Timothy J LaytonHarvard University and NBER, United States of America. Electronic address: layton@hcp.med.harvard.edu.
Mark ShepardHarvard University and NBER, United States of America. Electronic address: Mark_Shepard@hks.harvard.edu.
Jacob WallaceYale University, United States of America. Electronic address: jacob.wallace@yale.edu.

Funding

Tradeoffs in the Design of Public Long-Term Care BenefitsP01AG032952 · NIA · HARVARD MEDICAL SCHOOL · PI Bruce E. Landon · 2009 to 2026
$39.0M
NBER Center for Aging and Health Research-Post COVID-19 Experiences Among Adults with ADRDP30AG012810 · NIA · NATIONAL BUREAU OF ECONOMIC RESEARCH · PI DAVID M CUTLER · 1999 to 2026
$24.6M
NBER Training Program in Aging and Health EconomicsT32AG000186 · NIA · NATIONAL BUREAU OF ECONOMIC RESEARCH · PI CUTLER, DAVID M, FINKELSTEIN, AMY N. · 1989 to 2024
$9.6M
Health Policy Training Program: Promoting Outcomes, Quality, Equity and Diffusion of AdvancesT32MH019733 · NIMH · HARVARD UNIVERSITY (MEDICAL SCHOOL) · PI Benjamin Le Cook, Haiden A Huskamp · 1993 to 2026
$7.0M
Quality and Outcomes under Medicaid Managed Care: Evidence from Random Plan AssignmentK01HS025786 · AHRQ · HARVARD MEDICAL SCHOOL · PI LAYTON, TIMOTHY · 2018 to 2022
$737k
AHRQ HHS K01 HS025786NIA NIH HHS P01 AG032952NIA NIH HHS P30 AG012810NIA NIH HHS T32 AG000186NIMH NIH HHS T32 MH019733
6 · The paper itself

Abstract

Health plans for the poor increasingly limit access to specialty hospitals. We investigate the role of adverse selection in generating this equilibrium among private plans in Medicaid. Studying a network change, we find that covering a top cancer hospital causes severe adverse selection, increasing demand for a plan by 50% among enrollees with cancer versus no impact for others. Medicaid's fixed insurer payments make offsetting this selection, and the contract distortions it induces, challenging, requiring either infeasibly high payment rates or near-perfect risk adjustment. By contrast, a small explicit bonus for covering the hospital is sufficient to make coverage profitable.

Indexed as

MedicaidHumansInsurance CoverageNeoplasmsUnited StatesAdverse selectionCancer hospitalsMedicaid

Identifiers

PMID38944945
PMCPMC11392643

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.