Nothing for something? Estimating cost and value for beneficiaries from recent medicare spending increases on HMO payments and drug benefits

Steven D. Pizer, Austin B. Frakt, Roger Feldman

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

The Medicare Modernization Act of 2003 added a new outpatient prescription drug benefit to Medicare and increased payments to HMOs. We estimate a nested logit model of plan choice to quantify the welfare benefits from these two expansion paths. We find that the addition of stand-alone prescription drug plans was welfare improving and produced nine times as much value per government dollar as the increase in payments to HMOs. In light of these results, we suggest that HMO bidding procedures should be modified to reduce payments to HMOs by about $67 billion over the next 10 years.

Original languageEnglish (US)
Pages (from-to)59-81
Number of pages23
JournalInternational journal of health care finance and economics
Volume9
Issue number1
DOIs
StatePublished - Jan 1 2009

Keywords

  • Choice models
  • HMO payment
  • Medicare
  • Welfare

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