Scholars@Duke
M. Kate Bundorf

M. Kate Bundorf

J. Alexander McMahon Distinguished Professor of Health Policy and Management
Sanford School of Public Policy
kate.bundorf@duke.edu
Box 90312, Durham, NC 27708
278 Rubenstein Hall, Box 90312, Durham, NC 27708
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Selected Publications

Systemic treatments for advanced prostate cancer: relationship between health insurance plan and treatment costs.

Journal Article Am J Manag Care · September 1, 2024 OBJECTIVES: The high costs of cancer care can cause significant harm to patients and society. Prostate cancer, the leading nonskin malignancy in men, is responsible for the second-highest out-of-pocket (OOP) payments among all malignancies. Multiple first- ... Full text Link to item Cite

Long-Term Engagement of Patients With Advanced Cancer: Results From the EPAC Randomized Clinical Trial.

Journal Article JAMA oncology · July 2024 ImportanceThe long-term effect of interventions that assist patients with establishing their end-of-life care preferences among patients with cancer remain relatively unknown.ObjectiveTo evaluate the association of a long-term interventio ... Full text Cite

How Do Consumers Interact with Digital Expert Advice? Experimental Evidence from Health Insurance

Journal Article Management Science · January 9, 2024 Consumers increasingly use digital advice when making purchasing decisions. How do such tools change consumer behavior and what types of consumers are likely to use them? We examine these questions with a randomized controlled trial of digital exp ... Full text Cite

Changes in emergency department use associated with Medicaid expansion under the Affordable Care Act: A comparison of waiver and traditional expansion states.

Journal Article Journal of the American College of Emergency Physicians open · December 2023 ObjectiveTo determine whether changes in emergency department use associated with Medicaid expansions differed between states undergoing waiver and traditional expansions.MethodsDesign: This study was a cross-sectional difference-in-diffe ... Full text Cite

Association Between Cervical Cancer Screening Guidelines and Preterm Delivery Among Females Aged 18 to 24 Years.

Journal Article JAMA health forum · July 2023 ImportanceCervical cancer screening is associated with reduced cervical cancer mortality; however, clinical trials have also shown an association between excisional procedures for cervical neoplasia and an increased risk of preterm delivery (PTD). ... Full text Cite

Health Care Use and Spending Among Need-Based Subgroups of Medicare Beneficiaries With Full Medicaid Benefits.

Journal Article JAMA Health Forum · May 5, 2023 IMPORTANCE: Beneficiaries dual eligible for Medicare and Medicaid account for a disproportionate share of expenditures due to their complex care needs. Lack of coordination between payment programs creates misaligned incentives, resulting in higher costs, ... Full text Link to item Cite

Medication Payments by Insurers and Patients for the Treatment of Metastatic Castrate-Resistant Prostate Cancer.

Journal Article JCO Oncol Pract · April 2023 PURPOSE: The implications of high prices for cancer drugs on health care costs and patients' financial burdens are a growing concern. Patients with metastatic castrate-resistant prostate cancer (mCRPC) are often candidates for multiple first-line systemic ... Full text Link to item Cite

Employer-Sponsored Coverage Stabilized And Uninsurance Declined In The Second Year Of The COVID-19 Pandemic.

Journal Article Health affairs (Project Hope) · January 2023 The health risks of COVID-19, combined with widespread economic instability in the US, spurred Congress to pass temporary measures to improve access to health insurance. Using data from the Household Pulse Survey, a high-frequency, population-based survey, ... Full text Cite

THE RESPONSIVENESS OF MEDICAID SPENDING TO THE FEDERAL SUBSIDY

Journal Article National Tax Journal · December 1, 2022 Although economic theory suggests that the federal government can influence spending by states through subsidies to programs that states operate, no recent work has quantified the magnitude of this effect for Medicaid, the largest program of this type in t ... Full text Cite

Association Between High-Deductible Health Plans and Hernia Acuity.

Journal Article JAMA surgery · April 2022 ImportanceAbout half of people younger than 65 years with private insurance are enrolled in a high-deductible health plan (HDHP). While these plans entail substantially higher out-of-pocket costs for patients with chronic medical conditions who re ... Full text Cite

Providing more balanced information on the harms and benefits of cervical cancer screening: A randomized survey among US and Norwegian women.

Journal Article Preventive medicine reports · September 2021 We aimed to identify how additional information about benefits and harms of cervical cancer (CC) screening impacted intention to participate in screening, what type of information on harms women preferred receiving, from whom, and whether it differed betwe ... Full text Cite

Trends in US Health Insurance Coverage During the COVID-19 Pandemic.

Journal Article JAMA health forum · September 2021 ImportanceWhile most working-age adults in the US obtain health insurance through an employer, little is known about the implications of the massive pandemic-related job loss in March 2020 and subsequent rebound for rates of employer-sponsored cov ... Full text Cite

Analysis of Publicly Funded Reinsurance-Government Spending and Insurer Risk Exposure.

Journal Article JAMA health forum · August 2021 This analysis compares the design of section 1332 reinsurance policies across states based on their potential for reducing insurer risk exposure and likely level of government spending. ... Full text Cite

The Role of Physician-Driven Device Preference in the Cost Variation of Common Interventional Radiology Procedures.

Journal Article Journal of vascular and interventional radiology : JVIR · May 2021 PurposeTo analyze the impact of physician-specific equipment preference on cost variation for procedures typically performed by interventional radiologists at a tertiary care academic hospital.Materials and methodsFrom October 2017 to Oct ... Full text Cite

Cataract Surgery Complexity and Surgical Complication Rates Among Medicare Beneficiaries With and Without Dementia.

Journal Article American journal of ophthalmology · January 2021 PurposeTo evaluate cataract surgery complexity and complications among US Medicare beneficiaries with and without dementia.DesignRetrospective claims-based cohort study.ParticipantsA 20% representative sample of Medicare benefici ... Full text Cite

Receipt of Eye Care Services among Medicare Beneficiaries with and without Dementia.

Conference Ophthalmology · August 2020 PurposeTo examine the relationship between dementia status and receipt of eye care among US Medicare beneficiaries.DesignRetrospective, claims-based analysis.ParticipantsA 20% representative sample of Medicare beneficiaries who r ... Full text Cite

Association Between HEDIS Performance and Primary Care Physician Age, Group Affiliation, Training, and Participation in ACA Exchanges.

Journal Article Journal of general internal medicine · June 2020 BackgroundThere are a limited number of studies investigating the relationship between primary care physician (PCP) characteristics and the quality of care they deliver.ObjectiveTo examine the association between PCP performance and physi ... Full text Cite

Systemic treatments for advanced prostate cancer: relationship between health insurance plan and treatment costs.

Journal Article Am J Manag Care · September 1, 2024 OBJECTIVES: The high costs of cancer care can cause significant harm to patients and society. Prostate cancer, the leading nonskin malignancy in men, is responsible for the second-highest out-of-pocket (OOP) payments among all malignancies. Multiple first- ... Full text Link to item Cite

Long-Term Engagement of Patients With Advanced Cancer: Results From the EPAC Randomized Clinical Trial.

Journal Article JAMA oncology · July 2024 ImportanceThe long-term effect of interventions that assist patients with establishing their end-of-life care preferences among patients with cancer remain relatively unknown.ObjectiveTo evaluate the association of a long-term interventio ... Full text Cite

How Do Consumers Interact with Digital Expert Advice? Experimental Evidence from Health Insurance

Journal Article Management Science · January 9, 2024 Consumers increasingly use digital advice when making purchasing decisions. How do such tools change consumer behavior and what types of consumers are likely to use them? We examine these questions with a randomized controlled trial of digital exp ... Full text Cite

Changes in emergency department use associated with Medicaid expansion under the Affordable Care Act: A comparison of waiver and traditional expansion states.

Journal Article Journal of the American College of Emergency Physicians open · December 2023 ObjectiveTo determine whether changes in emergency department use associated with Medicaid expansions differed between states undergoing waiver and traditional expansions.MethodsDesign: This study was a cross-sectional difference-in-diffe ... Full text Cite

Association Between Cervical Cancer Screening Guidelines and Preterm Delivery Among Females Aged 18 to 24 Years.

Journal Article JAMA health forum · July 2023 ImportanceCervical cancer screening is associated with reduced cervical cancer mortality; however, clinical trials have also shown an association between excisional procedures for cervical neoplasia and an increased risk of preterm delivery (PTD). ... Full text Cite

Health Care Use and Spending Among Need-Based Subgroups of Medicare Beneficiaries With Full Medicaid Benefits.

Journal Article JAMA Health Forum · May 5, 2023 IMPORTANCE: Beneficiaries dual eligible for Medicare and Medicaid account for a disproportionate share of expenditures due to their complex care needs. Lack of coordination between payment programs creates misaligned incentives, resulting in higher costs, ... Full text Link to item Cite

Medication Payments by Insurers and Patients for the Treatment of Metastatic Castrate-Resistant Prostate Cancer.

Journal Article JCO Oncol Pract · April 2023 PURPOSE: The implications of high prices for cancer drugs on health care costs and patients' financial burdens are a growing concern. Patients with metastatic castrate-resistant prostate cancer (mCRPC) are often candidates for multiple first-line systemic ... Full text Link to item Cite

Employer-Sponsored Coverage Stabilized And Uninsurance Declined In The Second Year Of The COVID-19 Pandemic.

Journal Article Health affairs (Project Hope) · January 2023 The health risks of COVID-19, combined with widespread economic instability in the US, spurred Congress to pass temporary measures to improve access to health insurance. Using data from the Household Pulse Survey, a high-frequency, population-based survey, ... Full text Cite

THE RESPONSIVENESS OF MEDICAID SPENDING TO THE FEDERAL SUBSIDY

Journal Article National Tax Journal · December 1, 2022 Although economic theory suggests that the federal government can influence spending by states through subsidies to programs that states operate, no recent work has quantified the magnitude of this effect for Medicaid, the largest program of this type in t ... Full text Cite

Association Between High-Deductible Health Plans and Hernia Acuity.

Journal Article JAMA surgery · April 2022 ImportanceAbout half of people younger than 65 years with private insurance are enrolled in a high-deductible health plan (HDHP). While these plans entail substantially higher out-of-pocket costs for patients with chronic medical conditions who re ... Full text Cite

Providing more balanced information on the harms and benefits of cervical cancer screening: A randomized survey among US and Norwegian women.

Journal Article Preventive medicine reports · September 2021 We aimed to identify how additional information about benefits and harms of cervical cancer (CC) screening impacted intention to participate in screening, what type of information on harms women preferred receiving, from whom, and whether it differed betwe ... Full text Cite

Trends in US Health Insurance Coverage During the COVID-19 Pandemic.

Journal Article JAMA health forum · September 2021 ImportanceWhile most working-age adults in the US obtain health insurance through an employer, little is known about the implications of the massive pandemic-related job loss in March 2020 and subsequent rebound for rates of employer-sponsored cov ... Full text Cite

Analysis of Publicly Funded Reinsurance-Government Spending and Insurer Risk Exposure.

Journal Article JAMA health forum · August 2021 This analysis compares the design of section 1332 reinsurance policies across states based on their potential for reducing insurer risk exposure and likely level of government spending. ... Full text Cite

The Role of Physician-Driven Device Preference in the Cost Variation of Common Interventional Radiology Procedures.

Journal Article Journal of vascular and interventional radiology : JVIR · May 2021 PurposeTo analyze the impact of physician-specific equipment preference on cost variation for procedures typically performed by interventional radiologists at a tertiary care academic hospital.Materials and methodsFrom October 2017 to Oct ... Full text Cite

Cataract Surgery Complexity and Surgical Complication Rates Among Medicare Beneficiaries With and Without Dementia.

Journal Article American journal of ophthalmology · January 2021 PurposeTo evaluate cataract surgery complexity and complications among US Medicare beneficiaries with and without dementia.DesignRetrospective claims-based cohort study.ParticipantsA 20% representative sample of Medicare benefici ... Full text Cite

Receipt of Eye Care Services among Medicare Beneficiaries with and without Dementia.

Conference Ophthalmology · August 2020 PurposeTo examine the relationship between dementia status and receipt of eye care among US Medicare beneficiaries.DesignRetrospective, claims-based analysis.ParticipantsA 20% representative sample of Medicare beneficiaries who r ... Full text Cite

Association Between HEDIS Performance and Primary Care Physician Age, Group Affiliation, Training, and Participation in ACA Exchanges.

Journal Article Journal of general internal medicine · June 2020 BackgroundThere are a limited number of studies investigating the relationship between primary care physician (PCP) characteristics and the quality of care they deliver.ObjectiveTo examine the association between PCP performance and physi ... Full text Cite

The effects of medicare advantage on opioid use.

Journal Article Journal of health economics · March 2020 Featured Publication Despite a vast literature on the determinants of prescription opioid use, the role of health insurance plans has received little attention. We study how the form of Medicare beneficiaries' drug coverage affects the volume of opioids they consume. We find t ... Full text Cite

Online Consent Enables a Randomized, Controlled Trial Testing a Patient-Centered Online Decision-Aid for Medicare Beneficiaries to Meet Recruitment Goal in Short Time Frame.

Journal Article Journal of patient experience · February 2020 Online consenting allows potential participants of research projects to deliberate their participation at their own pace and may be more cost-effective than conventional approaches. Yet, online consenting is not widespread in health services research due p ... Full text Cite

ACA Medicaid Expansion Associated With Increased Medicaid Participation and Improved Health Among Near-Elderly: Evidence From the Health and Retirement Study.

Journal Article Inquiry : a journal of medical care organization, provision and financing · January 2020 Featured Publication The Affordable Care Act (ACA) dramatically expanded health insurance, but questions remain regarding its effects on health. We focus on older adults for whom health insurance has greater potential to improve health and well-being because of their greater h ... Full text Cite

Does Multispecialty Practice Enhance Physician Market Power?

Scholarly Edition · January 2020 In health care, vertical integration - common ownership of producers of complementary services - may have both pro- and anti-competitive effects. We use data on 40 million commercially-insured individuals from the Health Care Cost Institute to construct pr ... Full text Cite

Lay Health Worker-Led Cancer Symptom Screening Intervention and the Effect on Patient-Reported Satisfaction, Health Status, Health Care Use, and Total Costs: Results From a Tri-Part Collaboration.

Journal Article JCO oncology practice · January 2020 PurposePoor patient experiences and increasing costs from undertreated symptoms require approaches that improve patient-reported outcomes and lower expenditures. We developed and evaluated the effect of a lay health worker (LHW)-led symptom screen ... Full text Cite

Why don't commercial health plans use prospective payment?

Scholarly Edition · October 1, 2019 One of the key terms in contracts between hospitals and insurers is how the parties apportion the financial risk of treating unexpectedly costly patients. “Prospective” payment contracts give hospitals a lump-sum amount, depending on the medical condition ... Full text Cite

Sex Differences in Treatment Strategies Among Patients With Ulcerative Colitis: A Retrospective Cohort Analysis of Privately Insured Patients.

Journal Article Diseases of the colon and rectum · May 2019 BackgroundSex-based treatment disparities occur in many diseases. Women undergo fewer procedural interventions, and their care is less consistent with guideline-based therapy. There is limited research exploring sex-based differences in ulcerative ... Full text Cite

Relationship between physician financial incentives and clinical pathway compliance: a cross-sectional study of 18 public hospitals in China.

Journal Article BMJ open · May 2019 ObjectivesMany strategies have been either used or recommended to promote physician compliance with clinical practice guidelines and clinical pathways (CPs). This study examines the relationship between hospitals' use of financial incentives to en ... Full text Cite

Comparative Usability Study of a Newly Created Patient-Centered Tool and Medicare.gov Plan Finder to Help Medicare Beneficiaries Choose Prescription Drug Plans.

Journal Article Journal of patient experience · March 2019 IntroductionIn response to reported difficulties in selecting a Medicare Part D prescription drug plan, we designed a patient-centered online Part D plan selection tool (CHOICE1.0) to simplify the selection process and to provide personalized, exp ... Full text Cite

Machine-Based Expert Recommendations And Insurance Choices Among Medicare Part D Enrollees.

Journal Article Health affairs (Project Hope) · March 2019 Featured Publication Choosing a health insurance plan is difficult for many people, and patient-centered decision support may help consumers make these choices. We tested whether providing a patient-centered decision-support tool-with or without machine-based, personalized exp ... Full text Cite

How does information on the harms and benefits of cervical cancer screening alter the intention to be screened?: a randomized survey of Norwegian women.

Journal Article European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation (ECP) · March 2019 Cervical cancer (CC) is the 13th most frequent cancer among women in Norway, but the third most common among women aged 25-49 years. The national screening program sends information letters to promote screening participation. We aimed to evaluate how women ... Full text Cite

Health Care System Factors Associated with Transition Preparation in Youth with Special Health Care Needs.

Journal Article Population health management · February 2019 The aim of this study was to assess: (1) the proportion of youth with special health care needs (YSHCN) with adequate transition preparation, (2) whether transition preparation differs by individual, condition-related and health care system-related factors ... Full text Cite

Competition in Outpatient Procedure Markets.

Journal Article Medical care · January 2019 BackgroundMore than half of all medical procedures performed in the United States occur in an outpatient setting, yet few studies have explored how competition among ambulatory surgery centers (ASCs) and hospitals affects prices for commercially i ... Full text Cite

Differences in Cataract Surgery Rates Based on Dementia Status.

Journal Article Journal of Alzheimer's disease : JAD · January 2019 BackgroundCataract surgery substantially improves patient quality of life. Despite the rising prevalence of dementia in the US, little is known about use of cataract surgery among this group.ObjectiveTo evaluate the relationship between d ... Full text Cite

Differences in Receiving Eye Care Based on Dementia Status

Conference INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE · 2019 Cite

Contrasting Effectiveness and Cost-Effectiveness of Colorectal Cancer Screening Under Commercial Insurance vs. Medicare.

Journal Article The American journal of gastroenterology · December 2018 ObjectivesMost cost-effectiveness analyses of colorectal cancer (CRC) screening assume Medicare payment rates and a lifetime horizon. Our aims were to examine the implications of differential payment levels and time horizons for commercial insurer ... Full text Cite

Effect of a Lay Health Worker Intervention on Goals-of-Care Documentation and on Health Care Use, Costs, and Satisfaction Among Patients With Cancer: A Randomized Clinical Trial.

Journal Article JAMA oncology · October 2018 Featured Publication ImportanceAlthough lay health workers (LHWs) improve cancer screening and treatment adherence, evidence on whether they can enhance other aspects of care is limited.ObjectiveTo determine whether an LHW program can increase documentation o ... Full text Cite

Patient Experiences in Selecting a Medicare Part D Prescription Drug Plan.

Journal Article Journal of patient experience · June 2018 IntroductionMedicare beneficiaries often report that the process of choosing a prescription drug plan is frustrating and confusing and many do not enroll in the plan that covers their drugs at the lowest cost.MethodsWe conducted 4 focus g ... Full text Cite

An Analysis of Medicare Reimbursement to Ophthalmologists: Years 2012 to 2013.

Journal Article American journal of ophthalmology · February 2018 Full text Cite

ACA Marketplace premiums and competition among hospitals and physician practices.

Journal Article The American journal of managed care · February 2018 ObjectivesTo examine the association between annual premiums for health plans available in Federally Facilitated Marketplaces (FFMs) and the extent of competition and integration among physicians and hospitals, as well as the number of insurers. Cite

Hospital Ownership of Physicians: Hospital Versus Physician Perspectives.

Journal Article Medical care research and review : MCRR · February 2018 Although there has been significant interest from health services researchers and policy makers about recent trends in hospitals' ownership of physician practices, few studies have investigated the strengths and weaknesses of available data sources. In thi ... Full text Cite

Marketplace Plans Provide Risk Protection, But Actuarial Values Overstate Realized Coverage For Most Enrollees.

Journal Article Health affairs (Project Hope) · December 2017 Featured Publication The Affordable Care Act (ACA) has increased the number of Americans with health insurance. Yet many policy makers and consumers have questioned the value of Marketplace plan coverage because of the generally high levels of cost sharing. We simulated out-of ... Full text Cite

An Analysis of Medicare Reimbursement to Ophthalmologists: Years 2012 to 2013.

Journal Article American journal of ophthalmology · October 2017 PurposeTo analyze trends in utilization and payment of ophthalmic services in the Medicare population for years 2012 and 2013.DesignRetrospective, cross-sectional study.MethodsA retrospective cross-sectional observational analysi ... Full text Cite

Mortality In Rural China Declined As Health Insurance Coverage Increased, But No Evidence The Two Are Linked.

Journal Article Health affairs (Project Hope) · September 2017 Featured Publication Health insurance holds the promise of improving population health and survival and protecting people from catastrophic health spending. Yet evidence from lower- and middle-income countries on the impact of health insurance is limited. We investigated wheth ... Full text Cite

Cardiovascular Testing and Clinical Outcomes in Emergency Department Patients With Chest Pain.

Journal Article JAMA internal medicine · August 2017 ImportanceNoninvasive testing and coronary angiography are used to evaluate patients who present to the emergency department (ED) with chest pain, but their effects on outcomes are uncertain.ObjectiveTo determine whether cardiovascular te ... Full text Cite

As Infliximab Use for Ulcerative Colitis Has Increased, so Has the Rate of Surgical Resection.

Journal Article Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · July 2017 BackgroundInfliximab was approved for ulcerative colitis in 2005 after randomized trials showed it reduced the risk of colectomy. Its effect on population-level surgery rates is unknown. Our aim is to assess the impact of infliximab approval for u ... Full text Cite

Disrupting end-of-life cancer care delivery: Results from the engagment of patients with advanced cancer trial.

Conference Journal of Clinical Oncology · May 20, 2017 6525 Background: Sustainable approaches to improve quality and safety of care of patients with advanced cancer while concurrently reducing costs is a growing national need. As part of the Veterans Administration Engagement of Pat ... Full text Cite

Health insurance and chronic disease control: Quasi-experimental evidence from hypertension in rural China

Chapter · January 1, 2017 Introduction Hypertension (i.e., high blood pressure) is the epitome of a prevalent risk factor for chronic disease in China (as noted in prior chapters). This condition could be better controlled by successful implementation of the country’s reform effort ... Full text Cite

The effect of hospital/physician integration on hospital choice.

Journal Article Journal of health economics · December 2016 Featured Publication In this paper, we estimate how hospital ownership of physicians' practices affects their patients' hospital choices. We match data on the hospital admissions of Medicare beneficiaries, including the identity of their physician, with data on the identity of ... Full text Cite

Cost of Ulcerative Colitis Care has Increased in the Biologic Era

Conference Journal of the American College of Surgeons · October 2016 Full text Cite

Medicare Advantage Plans Pay Hospitals Less Than Traditional Medicare Pays.

Journal Article Health affairs (Project Hope) · August 2016 Featured Publication There is ongoing debate about how prices paid to providers by Medicare Advantage plans compare to prices paid by fee-for-service Medicare. We used data from Medicare and the Health Care Cost Institute to identify the prices paid for hospital services by fe ... Full text Cite

Physician Utilization Patterns for VEGF-Inhibitor Drugs in the 2012 United States Medicare Population: Bevacizumab, Ranibizumab, and Aflibercept.

Journal Article Ophthalmic surgery, lasers & imaging retina · June 2016 Background and objectiveTo evaluate variation in physician use of vascular endothelial growth factor (VEGF) inhibitors.Patients and methodsPopulation-based analysis of comprehensive, publicly available 2012 Medicare claims, aggregated by ... Full text Cite

Consumer-directed health plans: A review of the evidence

Journal Article Journal of Risk and Insurance · March 1, 2016 The number of people enrolled in consumer-directed health plans (CDHPs) has increased dramatically over the last decade. We review the empirical literature on the effects of CDHPs, which is based on the experience of these plans in the employer-sponsored m ... Full text Cite

Does health plan generosity enhance hospital market power?

Journal Article Journal of health economics · December 2015 We test whether the generosity of employer-sponsored health insurance facilitates the exercise of market power by hospitals. We construct indices of health plan generosity and the price and volume of hospital services using data from Truven MarketScan for ... Full text Cite

Compliance with clinical pathways for inpatient care in Chinese public hospitals.

Journal Article BMC health services research · October 2015 BackgroundThe National Health and Family Planning Commission of China has issued more than 400 clinical pathways to improve the effectiveness and efficiency of medical care delivered by public hospitals in China. The aim of our study is to determi ... Full text Cite

ANTITRUST FOR ACCOUNTABLE CARE ORGANIZATIONS

Journal Article Journal of Competition Law and Economics · June 1, 2015 Full text Cite

Treating age-related macular degeneration: comparing the use of two drugs among medicare and veterans affairs populations.

Journal Article Health affairs (Project Hope) · February 2015 While new biologics have revolutionized the treatment of age-related macular degeneration-the leading cause of severe vision loss among older adults-these new drugs have also raised concerns over the economic impact of medical innovation. The two leading a ... Full text Cite

Survey on patient safety climate in public hospitals in China.

Journal Article BMC health services research · February 2015 BackgroundPatient safety climate has been recognized as a core determinant for improving safety in hospitals. Describing workforce perceptions of patient safety climate is an important part of safety climate management. This study aimed to describ ... Full text Cite

Expanding Patients' Property Rights in Their Medical Records

Journal Article American Journal of Health Economics · January 2015 Full text Cite

Colorectal testing utilization and payments in a large cohort of commercially insured US adults.

Journal Article The American journal of gastroenterology · October 2014 ObjectivesScreening decreases colorectal cancer (CRC) mortality. The national press has scrutinized colonoscopy charges. Little systematic evidence exists on colorectal testing and payments among commercially insured persons. Our aim was to charac ... Full text Cite

Physician practice competition and prices paid by private insurers for office visits.

Journal Article JAMA · October 2014 Featured Publication ImportancePhysician practice consolidation could promote higher-quality care but may also create greater economic market power that could lead to higher prices for physician services.ObjectiveTo assess the relationship between physician c ... Full text Cite

Comments and discussion

Journal Article Brookings Papers on Economic Activity · July 28, 2014 Full text Cite

Patients' preferences explain a small but significant share of regional variation in medicare spending.

Journal Article Health affairs (Project Hope) · June 2014 This study assessed the extent to which differences in patients' preferences across geographic areas explained differences in traditional fee-for-service Medicare spending across Dartmouth Atlas of Health Care Hospital Referral Regions (HRRs). Preference m ... Full text Cite

Vertical integration: hospital ownership of physician practices is associated with higher prices and spending.

Journal Article Health affairs (Project Hope) · May 2014 Featured Publication We examined the consequences of contractual or ownership relationships between hospitals and physician practices, often described as vertical integration. Such integration can reduce health spending and increase the quality of care by improving communicati ... Full text Cite

Enrollment in prescription drug insurance: the interaction of numeracy and choice set size.

Journal Article Health psychology : official journal of the Division of Health Psychology, American Psychological Association · April 2014 ObjectiveTo determine how choice set size affects decision quality among individuals of different levels of numeracy choosing prescription drug plans.MethodMembers of an Internet-enabled panel age 65 and over were randomly assigned to set ... Full text Cite

Why Are Medicare and commercial insurance spending weakly correlated?

Journal Article The American journal of managed care · January 2014 ObjectiveTo investigate the source of the weak correlation across geographic areas between Medicare and private insurance spending.Study designRetrospective, descriptive analysis.MethodsWe obtained Medicare spending data at the h ... Cite

Consumer and managerial goals in assortment choice and design

Conference Marketing Letters · January 1, 2014 In many domains, consumers must deal with an increasing number of choices-spanning where, when, what, and how many items to buy; how many and which options to consider; and how best to weigh the pros and cons of these options. This paper considers how cons ... Full text Cite

Are prescription drug insurance choices consistent with expected utility theory?

Journal Article Health psychology : official journal of the Division of Health Psychology, American Psychological Association · September 2013 ObjectiveTo determine the extent to which people make choices inconsistent with expected utility theory when choosing among prescription drug insurance plans and whether tabular or graphical presentation format influences the consistency of their ... Full text Cite

Private insurers' payments for routine physician office visits vary substantially across the United States.

Journal Article Health affairs (Project Hope) · September 2013 Featured Publication Anecdotal reports suggest that substantial variation exists in private insurers' payments for physician services, but systematic evidence is lacking. Using a retrospective analysis of insurance claims for routine office visits, consultations, and preventiv ... Full text Cite

The association of strategic group and organizational culture with hospital performance in China.

Journal Article Health care management review · July 2013 BackgroundThe policy environment in China is rapidly changing. Strategic planning may enable hospitals to respond more effectively to changes in their external environment, little evidence exists on the extent to which public hospitals in China ad ... Full text Cite

Pricing and Welfare in Health Plan Choice.

Journal Article The American economic review · December 2012 Featured Publication Premiums in health insurance markets frequently do not reflect individual differences in costs, either because consumers have private information or because prices are not risk rated. This creates inefficiencies when consumers self-select into plans. We de ... Full text Cite

Organizational culture and its relationship with hospital performance in public hospitals in China.

Journal Article Health services research · December 2011 ObjectiveTo measure perceptions of organizational culture among employees of public hospitals in China and to determine whether perceptions are associated with hospital performance.Data sourcesHospital, employee, and patient surveys from ... Full text Cite

Age and the purchase of prescription drug insurance by older adults.

Journal Article Psychology and aging · June 2011 The Medicare Part D Prescription Drug Program places an unprecedented degree of choice in the hands of older adults despite concerns over their ability to make effective decisions and desire to have extensive choice in this context. While previous research ... Full text Cite

Health Care Spending Risk, Health Insurance, and Payment to Health Plans

Chapter · January 1, 2011 This chapter will deal with the actual and efficient functioning of health insurance in settings where risk (expected value) of medical spending or insurance benefits varies across individuals at a given point in time or over time for a given individual. I ... Full text Cite

Insurance mandates, embryo transfer, outcomes--the link is tenuous.

Journal Article Fertility and sterility · December 2010 To examine the relationship between state insurance mandate status and the number of embryos transferred in assisted reproductive technology cycles, we conducted a retrospective analysis of clinics reporting to the publicly available national Society for A ... Full text Cite

HMO coverage reduces variations in the use of health care among patients under age sixty-five.

Journal Article Health affairs (Project Hope) · November 2010 Variation in the use of hospital and physician services among Medicare beneficiaries is well documented. However, less is known about the younger, commercially insured population. Using data from the Community Tracking Study to investigate this issue, we f ... Full text Cite

Choice set size and decision making: the case of Medicare Part D prescription drug plans.

Journal Article Medical decision making : an international journal of the Society for Medical Decision Making · September 2010 BackgroundThe impact of choice on consumer decision making is controversial in US health policy.ObjectiveThe authors' objective was to determine how choice set size influences decision making among Medicare beneficiaries choosing prescrip ... Full text Cite

The effects of competition on assisted reproductive technology outcomes.

Journal Article Fertility and sterility · April 2010 ObjectiveTo evaluate the relationship between competition among fertility clinics and assisted reproductive technology (ART) treatment outcomes, particularly multiple births.DesignUsing clinic-level data from 1995 to 2001, we examined the ... Full text Cite

The effects of offering health plan choice within employment-based purchasing groups

Journal Article Journal of Risk and Insurance · March 1, 2010 Employers may offer employees a choice of health plans either to promote competition among plans or to better cater to employee preferences for different types of products. This article examines whether the relationship between the availability of choice a ... Full text Cite

United States

Chapter · 2010 Cite

Health care cost growth among the privately insured.

Journal Article Health affairs (Project Hope) · September 2009 Controlling health care cost growth remains a high priority for policymakers and private decisionmakers, yet little is known about sources of this growth. We examined spending growth among the privately insured between 2001 and 2006, separating the contrib ... Full text Cite

Does Health Insurance Make You Fat?

Journal Article · July 2009 Cite

Do markets respond to quality information? The case of fertility clinics.

Journal Article Journal of health economics · May 2009 Although policymakers have increasingly turned to provider report cards as a tool to improve health care quality, existing studies provide mixed evidence on whether they influence consumer choices. We examine the effects of providing consumers with quality ... Full text Cite

The incidence of the healthcare costs of obesity.

Journal Article Journal of health economics · May 2009 Who pays the healthcare costs associated with obesity? Among workers, this is largely a question of the incidence of the costs of employer-sponsored coverage. Using data from the National Longitudinal Survey of Youth and the Medical Expenditure Panel Surve ... Full text Cite

The incidence of the healthcare costs of obesity

Journal Article · May 2009 Who pays the healthcare costs associated with obesity? Among workers, this is largely a question of the incidence of the costs of employer-sponsored coverage. Using data from the National Longitudinal Survey of Youth and the Medical Expenditure Panel Surve ... Cite

Do markets respond to quality information? The case of fertility clinics

Journal Article · May 2009 Although policymakers have increasingly turned to provider report cards as a tool to improve health care quality, existing studies provide mixed evidence on whether they influence consumer choices. We examine the effects of providing consumers with quality ... Cite

Public Support for National Health Insurance: The Roles of Attitudes and Beliefs

Journal Article Forum for Health Economics & Policy · April 2008 The U.S. is the only developed country without some form of national health insurance. Yet, public opinion polls have consistently reported solid majorities in favor of such a system. In this paper, we examine whether attitudes toward different roles of ... Cite

Use and outcomes of intracytoplasmic sperm injection for non-male factor infertility

Journal Article Obstetrical and Gynecological Survey · February 1, 2008 Full text Cite

Health plan performance measurement: does it affect quality of care for Medicare managed care enrollees?

Journal Article Inquiry : a journal of medical care organization, provision and financing · January 2008 Although the objective of provider performance measurement is to improve quality of care, little evidence exists on whether it has this effect. This study examines the implementation of mandatory quality reporting for Medicare managed care (MMC) plans. We ... Full text Cite

Insurance mandates and trends in infertility treatments.

Journal Article Fertility and sterility · January 2008 ObjectiveTo examine the relationship between insurance mandates and the utilization and outcomes of assisted reproductive technologies (ART).DesignUsing clinic-level data from 1990 to 2001, we examined differences between states with and ... Full text Cite

Use and outcomes of intracytoplasmic sperm injection for non-male factor infertility.

Journal Article Fertility and sterility · September 2007 ObjectiveTo determine whether intracytoplasmic sperm injection (ICSI) is associated with improved outcomes for non-male factor infertility.DesignWe examined the patient characteristics associated with treatment choice-ICSI and conventiona ... Full text Cite

Is health insurance affordable for the uninsured?

Scholarly Edition · July 2006 In this paper, we investigate the meaning of "affordability" in the context of health insurance. Assessing the relationship between the affordability of coverage and the large number of uninsured in the U.S. is important for understanding the barriers to p ... Full text Cite

Who searches the internet for health information?

Journal Article Health services research · June 2006 ObjectiveTo determine what types of consumers use the Internet as a source of health information.Data sourcesA survey of consumer use of the Internet for health information conducted during December 2001 and January 2002.Study design< ... Full text Cite

The Effects of Rate Regulation on Demand for Supplemental Health Insurance

Journal Article The American economic review · May 2006 Full text Cite

Employer health insurance offerings and employee enrollment decisions.

Journal Article Health services research · October 2005 ObjectiveTo determine how the characteristics of the health benefits offered by employers affect worker insurance coverage decisions.Data sourcesThe 1996-1997 and the 1998-1999 rounds of the nationally representative Community Tracking St ... Full text Cite

Free internet access, the digital divide, and health information.

Journal Article Medical care · April 2005 BackgroundThe Internet has emerged as a valuable tool for health information. Half of the U.S. population lacked Internet access in 2001, creating concerns about those without access. Starting in 1999, a survey firm randomly invited individuals to ... Full text Cite

The magnitude and nature of risk selection in employer-sponsored health plans.

Journal Article Health services research · December 2004 ObjectiveTo determine whether health maintenance organizations (HMOs) attract enrollees who use relatively few medical resources and whether a simple risk-adjustment system could mitigate or eliminate the inefficiency associated with risk selectio ... Full text Cite

Use of the Internet for health information by the chronically ill.

Journal Article Preventing chronic disease · October 2004 IntroductionChronic conditions are among the leading causes of death and disability in the United States. The Internet is a source of health information and advice for individuals with chronic conditions and shows promise for helping individuals m ... Cite

Consumers' use of the Internet for health insurance.

Journal Article The American journal of managed care · September 2004 ObjectivesWe examined consumers' search for information about health insurance choices and their use of the Internet for that search and to manage health benefits.Study designWe surveyed a random sample of more than 4500 individuals aged ... Cite

Impact of managed care on the treatment, costs, and outcomes of fee-for-service Medicare patients with acute myocardial infarction.

Journal Article Health Serv Res · February 2004 OBJECTIVE: To examine the effects of market-level managed care activity on the treatment, cost, and outcomes of care for Medicare fee-for-service acute myocardial infarction (AMI) patients. DATA SOURCES/STUDY SETTING: Patients from the Cooperative Cardiova ... Full text Link to item Cite

Use of the Internet and e-mail for health care information: results from a national survey.

Journal Article JAMA · May 2003 ContextThe Internet has attracted considerable attention as a means to improve health and health care delivery, but it is not clear how prevalent Internet use for health care really is or what impact it has on health care utilization. Available es ... Full text Cite

Use of the Internet for health information and communication - Reply

Journal Article JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION · 2003 Cite

Employee demand for health insurance and employer health plan choices.

Journal Article Journal of health economics · January 2002 Although most private health insurance in US is employment-based, little is known about how employers choose health plans for their employees. In this paper, I examine the relationship between employee preferences for health insurance and the health plans ... Full text Cite

Consumer protection and the HMO backlash: are HMOs to blame for drive-through deliveries?

Journal Article Inquiry : a journal of medical care organization, provision and financing · January 1999 This study used patient discharge data from New Jersey to examine differences in length of stay for normal, uncomplicated deliveries between patients in health maintenance organizations (HMOs) and those not in HMOs. The percentage of one-day stays increase ... Cite

Does Health Plan Generosity Enhance Hospital Market Power?

Scholarly Edition We test whether the generosity of employer-sponsored health insurance facilitates the exercise of market power by hospitals. We construct indices of health plan generosity and the price and volume of hospital services using data from Truven MarketScan for ... Cite

The Effect of Hospital/Physician Integration on Hospital Choice

Scholarly Edition In this paper, we estimate how hospital ownership of physicians’ practices affects their patients’ hospital choices. We match data on the hospital admissions of Medicare beneficiaries, including the identity of their admitting physician, with data on the ... Cite

The Effects of Offering Health Plan Choice within Employment-Based Purchasing Groups

Scholarly Edition Over the last two decades, employers have increasingly offered workers a choice of health plans. The availability of choice has the potentially beneficial effects of lowering the cost and increasing the quality of health care through greater competition a ... Cite

Expanding Patients' Property Rights In Their Medical Records

Scholarly Edition Although doctors and hospitals own their patients' medical records, state and federal laws require that they provide patients with a copy at "reasonable cost." We examine the effects of state laws that cap the fees that doctors and hospitals are allowed ... Cite