Medicaid in ACA Marketplaces: The Welfare Impact of New Hampshire's Medicaid Experiment (Job Market Paper)
Other Working Papers
“Sources of Variation in Hospital Prices: The Roles of Bargaining Leverage and Other Factors” (joint paper)
Hospital spending on inpatient and outpatient care accounts for approximately 45% of US health care spending and is an important driver of overall growth in US health care costs. Despite the size and importance of this market, researchers have only recently begun to produce evidence documenting variation in hospital prices paid by private insurance. In this paper, we extend this literature using recently collected data from the RAND Hospital Price Transparency project. To examine sources of price variation, we first characterize the relative importance of geographic variation (across HRRs), hospital-level variation (across hospitals), insurer-level variation (within hospitals), and employer-level variation (controlling for hospital and insurer fixed effects) in explaining the overall variation observed in hospital prices. We next examine the extent to which variation in prices is consistent with existing models of bilateral price negotiation and construct semiparametric measures of consumer willingness-to-pay (WTP) for each hospital in our sample. For inpatient care, we find a positive association between hospital WTP and prices, but little relationship for outpatient. We find that nearly all price variation is explained by provider-specific characteristics, and little price variation is explained by patient, purchaser, or insurer characteristics. Our findings also suggest that price determination in the markets for inpatient and outpatient care may reflect very different processes.