Health Care Spending and Utilization in Public and Private Medicare
利用Medicare Advantage保险商的新索赔数据，比较公共与私人医疗保险的医疗支出，发现私人计划人均支出比传统Medicare低9%至30%，差异主要源于利用管理而非价格。
We compare health care spending in public and private Medicare using newly available claims data from Medicare Advantage (MA) insurers. MA insurer revenues are 30 percent higher than their health care spending. Adjusting for enrollee mix, health care spending per enrollee in MA is 9 to 30 percent lower than in Traditional Medicare (TM), depending on the way we define “comparable” enrollees. Spending differences primarily reflect differences in health care utilization, with similar reductions for “high-value” and “low-value” care, rather than health care prices. We present evidence consistent with MA plans encouraging substitution to less expensive care and engaging in utilization management.