Dual eligibles: A statistical overview

Medicare covers largely elderly individuals, the disabled, and individuals with end stage kidney disease. Medicaid covers low-income individuals. So who are dual eligibles, that qualify for both programs? The Medicaid and CHIP Payment and Access Commission (MACPAC) and the Medicare Payment Advisory Commission (MedPAC) put out a report last year providing a summary of the…

Do narrow networks save money?

According to a recent paper by Wallace (2023), the answer is ‘yes’, but it does so in a highly inefficient manner. Using 2008-2012 Medicaid data from the New York State Department of Health, the author find that: Leveraging the random assignment of over 50,000 Medicaid enrollees in New York, I present causal evidence that narrower…

Who pays more for hospital and physician services: commercial payers, Medicare or Medicaid? And how much more?

Many people might know that generally the answer is commercial health plans have the most generous reimbursement compared to government plans. However, a key question is how much more do they pay? Commercial vs. Medicare rates A January 2022 report by the Congressional Budget Office finds that commercial payers reimburse hospitals at 223% of Medicare…

Obesity Across America

The Urban Institute has an interesting report titled Obesity Across America. Being overweight (BMS>25), obese (BMI>30) or severely obese (BMI>40) is very common in the U.S. with three quarters of individuals being overweight and nearly half obese. Obesity varies by race and ethnicity as well. Black adults are more likely to live with obesity than…

Impact of drug coverage on mortality

Clayton 2019 is an interesting study on the impact of drug spending on Medicaid beneficiary mortality levels. The author uses variation in the roll out of Medicaid drug coverage by state across different Medicaid eligible groups in order to isolate plausibly exogenous variation in drug expenditures. Using this approach, Clayton finds that: …a $1 increase…