Patient Cost-Sharing and Hospitalization Offsets in the Elderly
研究加州退休公务员补充保险提高患者自付比例后，发现门诊和处方药使用减少，但住院增加，产生替代效应，节省归补充保险，成本转嫁至Medicare。
In the Medicare program, increases in cost sharing by a supplemental insurer can exert financial externalities. We study a policy change that raised patient cost sharing for the supplemental insurer for retired public employees in California. We find that physician visits and prescription drug usage have elasticities that are similar to those of the RAND Health Insurance Experiment (HIE). Unlike the HIE, however, we find substantial “offset” effects in terms of increased hospital utilization. The savings from increased cost sharing accrue mostly to the supplemental insurer, while the costs of increased hospitalization accrue mostly to Medicare.