Data and Code for: Healthcare Rationing in Public Insurance Programs: Evidence from Medicaid

Principal Investigator(s): View help for Principal Investigator(s) Timothy Layton, Harvard University; Nicole Maestas, Harvard University; Daniel Prinz, Institute for Fiscal Studies; Boris Vabson, Harvard University

Version: View help for Version V1

Name	File Type	Size	Last Modified
layton_maestas_prinz_vabson_code_and_data			10/20/2021 02:44:PM

Project Citation:

Layton, Timothy, Maestas, Nicole, Prinz, Daniel, and Vabson, Boris. Data and Code for: Healthcare Rationing in Public Insurance Programs: Evidence from Medicaid. Nashville, TN: American Economic Association [publisher], 2022. Ann Arbor, MI: Inter-university Consortium for Political and Social Research [distributor], 2022-10-20. https://doi.org/10.3886/E134661V1

Project Description

Summary: We study two mechanisms used by public health insurance programs for rationing healthcare: outsourcing to private managed care plans and quantity limits for prescription drugs. Leveraging a natural experiment in Texas's Medicaid program, we find that the shift to managed care and the relaxation of a strict drug cap increased access to high-value drugs and outpatient services and reduced avoidable hospitalizations. Program costs increased significantly, indicating a trade-off between cost and quality. We provide suggestive evidence attributing the reduction in hospitalizations to the relaxation of the drug cap and much of the spending increase to the shift to managed care.

Funding Sources: Laura and John Arnold Foundation; Social Security Administration / National Bureau of Economic Research Disability Research Center; National Institute on Aging (P30-AG012810); Agency for Healthcare Research and Quality (K01-HS25786-01)

Scope of Project

Subject Terms: Healthcare; Medicaid; Managed Care

JEL Classification:
      H51 National Government Expenditures and Health
      H53 National Government Expenditures and Welfare Programs
      H75 State and Local Government: Health; Education; Welfare; Public Pensions
      I13 Health Insurance, Public and Private
      I18 Health: Government Policy; Regulation; Public Health

Geographic Coverage: Texas

Time Period(s): 2004 – 2010

Collection Date(s): 2004 – 2010

Universe: Adult disabled Medicaid beneficiaries in Texas.

Data Type(s): administrative records data; aggregate data

Collection Notes: Research identifiable data accessed from the Centers for Medicare and Medicaid Services (CMS) through a data use agreement with the National Bureau of Economic Research (NBER). Code is provided, researcher must get their own data use agreement for most of the data.

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Published Versions

V1 [2022-10-20]

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