Crowd-Out and Emergency Department Utilization |
| |
| Institution: | 1. Fox School of Business, Temple University, USA;2. Department of Economics, Bentley University, USA;1. Sapienza University of Rome, Italy;2. University of Genoa, Italy;3. University of Verona, Italy;4. Institute of Economic Studies, Charles University, Czechia;1. Department of Economics, Centre for Health Economics, University of Gothenburg, Gothenburg, Sweden;2. Department of Economics, University of Central Florida, P.O. Box 161400, Orlando, FL 32816-1400, USA;1. School of Economics, Southwestern University of Finance and Economics, Chengdu, 611130, China;2. Department of Economics and Related Studies, University of York, York YO10 5DD, UK;1. Frank Batten School of Leadership & Public Policy University of Virginia, United States;2. Frank Batten School of Leadership & Public Policy, University of Virginia and National Bureau of Economic Research, United States |
| |
| Abstract: | When consumers gain Medicaid, their cost of healthcare changes. The direction of this change determines how utilization changes. The previously uninsured see a stark decrease in the price of primary care after gaining public insurance. Due to charity care, they may face an increase in the price of emergency department care. The previously insured see a reduction in emergency department prices and decreased access to primary care. We examine the impact of the prior insurance status of the newly publicly insured on substitution between healthcare. We base our identification on California’s LIHP and ACA Medicaid expansions. One challenge we face is estimating crowd-out. We use machine learning techniques to predict prior insurance status based on observable covariates in cross-sectional data. We find an increase in emergency department utilization caused entirely by those crowded-out whose access to primary care has decreased. We find the opposite utilization patterns for the previously uninsured. |
| |
| Keywords: | |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
