Medicare beneficiaries and the impact of gaining prescription drug coverage on inpatient and physician spending
UMass Chan Affiliations
Department of Medicine, Division of Geriatric MedicineMeyers Primary Care Institute
Document Type
Journal ArticlePublication Date
2005-10-22Keywords
AgedAged, 80 and over
Centers for Medicare and Medicaid Services (U.S.)
Fees, Pharmaceutical
Female
Health Care Surveys
Health Expenditures
Hospitalization
Humans
Insurance Claim Review
Insurance, Pharmaceutical Services
Male
Medicare
Middle Aged
Models, Econometric
Office Visits
United States
Health Services Research
Life Sciences
Medicine and Health Sciences
Primary Care
Metadata
Show full item recordAbstract
OBJECTIVE: To assess whether gaining prescription drug coverage produces cost offsets in Medicare spending on inpatient and physician services. DATA SOURCE: Two-year panels constructed from 1995 to 2000 Medicare Current Beneficiary Survey, a dataset of Medicare claims and health care surveys from the Medicare population. STUDY DESIGN: We estimated a series of fixed-effects panel models to calculate adjusted changes in Medicare spending as drug coverage was acquired (Gainers) relative to the spending of beneficiaries who never had drug coverage (Nevers). Explanatory variables in the model include age, calendar year, income, and health status. PRINCIPAL FINDINGS: Assessments of inpatient and physician services spending provided no evidence of overt selection behavior prior to the acquisition of drug coverage (i.e., there were no preswitch spikes in Medicare spending for Gainers). After enrollment, the medical spending of Gainers resembled those of beneficiaries who never had drug coverage. Overall, the multivariate models showed no systematic postenrollment changes in either inpatient or physician spending that could be attributed to the acquisition of drug coverage. CONCLUSIONS: We found no consistent evidence that drug coverage either increases or reduces spending for hospital and physician services. This does not necessarily mean that drug therapy does not substitute for or complement other medical treatments, but rather that neither effect predominates across the Medicare population as a whole.Source
Health Serv Res. 2005 Oct;40(5 Pt 1):1279-96. Link to article on publisher's siteDOI
10.1111/j.1475-6773.2005.00432.xPermanent Link to this Item
http://hdl.handle.net/20.500.14038/42254PubMed ID
16174134Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1111/j.1475-6773.2005.00432.x