Does Managed Care Widen Infant Health Disparities? Evidence from Texas Medicaid
研究了德克萨斯州医疗补助从按服务收费转向管理式医疗后，黑人和西班牙裔婴儿的健康差距如何扩大，发现黑人婴儿死亡率和早产率上升，而西班牙裔下降，这与风险选择模型一致。
Medicaid programs increasingly finance competing, capitated managed care plans rather than administering fee-for-service (FFS) programs. We study how the transition from FFS to managed care affects high- and low-cost infants (blacks and Hispanics, respectively). We find that black-Hispanic disparities widen—e.g., black mortality and preterm birth rates increase by 15 percent and 7 percent, respectively, while Hispanic mortality and preterm birth rates decrease by 22 percent and 7 percent, respectively. Our results are consistent with a risk-selection model whereby capitation incentivizes competing plans to offer better (worse) care to low- (high-) cost clients to retain (avoid) them in the future.