The Effect of Switching Private Insurance Plans on Health Care Utilization

2006 ◽  
Vol 5 (1) ◽  
Author(s):  
Fei Liu ◽  
David M. Zimmer
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Medical Expenditure Panel Survey ◽  
Unobserved Heterogeneity ◽  
Private Insurance ◽  
Medical Expenditure ◽  
Care Utilization ◽  
Panel Survey ◽  
Survey Results ◽  
Period Model

AbstractThe switching of health insurance plans and health care utilization are potentially correlated with both observable and unobservable information. This paper presents a two-period model of health care utilization, and attempts to account for unobserved heterogeneity that simultaneously affects utilization and the decision to switch plans. Data used in this paper are drawn from the Medical Expenditure Panel Survey. Results indicate that non-HMO enrollees increase their utilization of non-emergency related care prior to switching to HMOs, and they decrease utilization after switching. Conversely, individuals enrolled in HMOs report lower levels of utilization before and higher utilization after they switch to non-HMOs.

The Effect of the Consolidated Omnibus Reconciliation Act of 1985 on Health Care Utilization of Employment Separators

2008 ◽  
Vol 8 (2) ◽  
Author(s):  
David M. Zimmer
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Medical Expenditure Panel Survey ◽  
Simultaneous Equations ◽  
Medical Expenditure ◽  
Care Utilization ◽  
Panel Survey ◽  
Maximum Simulated Likelihood ◽  
Simulated Likelihood ◽  
Insurance Choice

Abstract This paper uses data from the Medical Expenditure Panel Survey to estimate the effect of COBRA on health care utilization among a sample of individuals who experience employment separation. The empirical specification employs a structural simultaneous equations model of insurance choice and utilization that is estimated by Maximum Simulated Likelihood. Results indicate that employment separators who elect COBRA appear to consume more health care compared to individuals who become temporarily uninsured. In addition, results do not indicate adverse selection into COBRA. Although COBRA enrollees consume more health care than temporary insurance losers, election appears to exhibit favorable selection with respect to physician utilization.

scholarly journals Estimated Health Care Utilization and Expenditures in Individuals With Heart Failure From the Medical Expenditure Panel Survey

2021 ◽  
Author(s):  
Sharon Klein ◽  
Shangqing Jiang ◽  
Jacob R. Morey ◽  
Akila Pai ◽  
Donna M. Mancini ◽  
...  
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Health Care Utilization ◽  
Medical Expenditure Panel Survey ◽  
Health Care Expenditures ◽  
Medical Expenditure ◽  
Care Utilization ◽  
Hospital Inpatient ◽  
Panel Survey ◽  
Medical Provider

Background: Heart failure (HF) constitutes a growing burden for public health and the US health care system. While the prevalence of HF is increasing, differences in health care utilization and expenditures within various sociodemographic groups remain poorly defined. Methods: We used the Medical Expenditure Panel Survey to assess annual health care utilization and expenditures from 2012 to 2017. Health care utilization was based on the annual frequency of various health care encounters. Annual total and out-of-pocket expenditures were evaluated for hospital inpatient stays, emergency room visits, outpatient visits, office-based medical provider visits, prescribed medicines, dental visits, home health aid visits, and other medical expenses. We performed univariable and multivariable regression analysis based on patient characteristics including sociodemographic and comorbidity variables. Results: Our results showed that total health care expenditures among patients with HF were $21 177 (95% CI, $18 819–$24 736) per year as compared with $5652 (95% CI, $5469–$5837) in those without HF ( P <0.001). Total expenditures within the population with HF were primarily being driven by expenditures associated with inpatient hospitalizations. Increasing number of comorbid conditions was associated with significant increases in total health care expenditures. Older age, female sex, earlier study years, number of comorbidities, higher level of education, and increasing family income brackets independently raised out-of-pocket expenditures. Conclusions: Our findings of increased health care utilization and expenditures based on sex, age, increasing number of comorbidities, wealthier income status, and increased education attainment level may be used for efforts aimed at better distributing health care resources to improve health outcomes in HF.

The Impacts of the COVID-19 Pandemic on the Medical Expenditure Panel Survey

2021 ◽  
Vol 111 (12) ◽  
pp. 2157-2166
Author(s):  
Samuel H. Zuvekas ◽  
David Kashihara
Keyword(s):  
Health Care ◽  
Medical Expenditure Panel Survey ◽  
Insurance Coverage ◽  
Response Rates ◽  
Medical Expenditure ◽  
Care Utilization ◽  
Panel Survey ◽  
Quality Of Data ◽  
Statistical Precision ◽  
The Impact

The COVID-19 pandemic caused substantial disruptions in the field operations of all 3 major components of the Medical Expenditure Panel Survey (MEPS). The MEPS is widely used to study how policy changes and major shocks, such as the COVID-19 pandemic, affect insurance coverage, access, and preventive and other health care utilization and how these relate to population health. We describe how the MEPS program successfully responded to these challenges by reengineering field operations, including survey modes, to complete data collection and maintain data release schedules. The impact of the pandemic on response rates varied considerably across the MEPS. Investigations to date show little effect on the quality of data collected. However, lower response rates may reduce the statistical precision of some estimates. We also describe several enhancements made to the MEPS that will allow researchers to better understand the impact of the pandemic on US residents, employers, and the US health care system. (Am J Public Health. 2021;111(12):2157–2166. https://doi.org/10.2105/AJPH.2021.306534 )

Abstract 127: Disparities in Total Health Care Expenditure, and Payment Type Related to Hypertension Between Non Hispanics and Hispanics in the USA: Results From the Medical Expenditure Panel Survey (2013 - 2014)

Hypertension ◽  
2017 ◽  
Vol 70 (suppl_1) ◽  
Author(s):  
Emir Veledar ◽  
Anshul Saxena ◽  
Emeka Osondu ◽  
Javier Valero Elizondo ◽  
Khurram Nasir
Keyword(s):  
Health Care ◽  
Emergency Room ◽  
Medical Expenditure Panel Survey ◽  
Private Insurance ◽  
Health Care Expenditure ◽  
Medical Expenditure ◽  
Inpatient Cost ◽  
Medication Cost ◽  
Panel Survey ◽  
The Usa

Background: Each year in the USA, more than 75 million adults are diagnosed with hypertension (HTN), but less than 54% have this condition under control. Due to poor management, mortality due to HTN or related complications was 410,000 in 2014 and resulted in close to $50 billion spent. We sought to examine disparities in the proportion of events and related expenditure due to HTN between 54 million Hispanics, representing 17% in the USA population and non Hispanics. Methods and Population: We used data from the Medical Expenditure Panel Survey (MEPS), the most complete source of data on the cost and use of health care and health insurance coverage for 2013 and 2014. Cost was grouped as related to ambulatory, emergency room, inpatient, home visits and medications. By source, payments were grouped as paid by family, MEDICARE, MEDICAID, private insurance, VA, Tricare and other. Results: Overall, there were 61.2 and 61.9 million total events associated with HTN in 2013 and 2014 respectively; Hispanics accounted for 5.8 (9.5%) and 5.4 (8.7%) million events each year. On an average, HTN events involving Hispanics were costlier up to $90 - $300 more than non Hispanics ($1053 vs. $ 746 in 2013; and $890 vs. $804 in 2014). For Hispanics, payments were mainly covered by MEDICAID (42.1%) and MEDICARE (27.5%), compared to MEDICARE (39.3%) and private insurance (23.7%) for non-Hispanic population. Hispanics HTN expenditures were $6.1 billion (12.9%) in 2013 and 5.3 billion (10.3%) in 2014 and Hispanics had disproportionately fewer number of events than expected 17%, and the structure of their costs for those events was not different from non-Hispanics. In regression model, accounting for demographics and type of insurance, being Hispanic was a significant predictor of the total, ambulatory and inpatient cost, but not emergency room or medication cost. Conclusion and Discussion: Hispanics participate disproportionately less in HTN events and costs compared to their proportion in population, even when age, demographic and socioeconomic factors are accounted for. They also have on average higher and more complex events compared with non Hispanics. Almost 70% of HTN expenditure for Hispanics in 2013-2014 was covered by MEDICAID and MEDICARE indicating socioeconomic disparities.

Abstract 215: GenderDisparities in Health Care Expenditure Among Patients With MI and Depression: ResultsFrom the Medical Expenditure Panel Survey 2014

2018 ◽  
Vol 11 (suppl_1) ◽  
Author(s):  
Emir Veledar ◽  
Anshul Saxena ◽  
Victor Okunrintemi ◽  
Javier Valero-Elizondo
Keyword(s):  
Health Care ◽  
Medical Expenditure Panel Survey ◽  
Survey Methods ◽  
Private Insurance ◽  
Health Care Expenditure ◽  
Medical Expenditure ◽  
Panel Survey ◽  
Cost Of Health Care ◽  
National Estimates ◽  
Gender Based

Introduction: Previous studies have linked depression and cardiovascular diseases, however gender differences in cost of hospitalization and care associated with events related to depression and myocardial infarction (MI) is not studied in detail. We utilized data from 2014 Medical Expenditure Panel Survey (MEPS) to evaluate national estimates of such costs. Hypothesis: Proportion of depression and MI and corresponding healthcare expenditures are high in general population and differ between genders. Also, payments are appropriated differently between payers. Methods: Participants from 2014 MEPS with events attributed to MI and/ or depression were included in this study. Mean (95% CI) event related cost, and total cost of health care was calculated using survey methods. Expenditure and utilization cost was grouped as related to ambulatory, emergency room, inpatient, home visits and medications. By source, payments were grouped as paid by family, MEDICARE, MEDICAID, private insurance, VA, Tricare and other. Results: There were 23486 participants in the study, representing 242,628,543 individuals in the US who were 20 years or above. Total health expenditure in 2014 among these was $1.5 trillion (Males: $696,940,498,022; Females: $837,486,094,699) with $27,937,582,549 attributed to depression (Males: $10,991,761,342; Females: $16,945,821,207) and $51,142,260,003 to MI (Males: $40,676,887,518; Females: $10,465,372,485). There were around 6,174,408 (2.5%) and 27,269,837 (11.2%) events associated with MI and depression respectively. Approximately 901,762 individuals reported both events. Among males, MI was 4,189,696 (3.6%) and among females, 1,984,711 (1.6%). Depression was reported 8,755,276 (7.5%) among males and 18,514,560 (14.6%) among females. Among females who were depressed, 2.3% reported MI, and 1.4% among those who were not depressed. Among males who were depressed, 5.4% reported MI and 3.4% among those who were not depressed. Among depressed males, AMI hospitalization was 0.31% whereas among depressed females, AMI hospitalization was 0.24%. Conclusion: Among both depressed and non-depressed populations, males had significantly higher proportion of MI and hospitalizations related to AMI when compared to females. But, out of total MI costs for males, less than 1% cost was accrued by depressed; whereas, of total MI cost for females, 9.6% of cost was accrued by depressed females showing gender based disparities in healthcare cost and utilization. With Medicare paying between 78%-83% of all MI costs, treating depression can result in significant savings.

scholarly journals Description, Health Care Utilization, and Outcomes for Home Health Care (HHC) COVID-19 Patients Early in the Pandemic: A Comparison to the General HHC Population

2021 ◽  
pp. 108482232110013
Author(s):  
Tami M. Videon ◽  
Robert J. Rosati ◽  
Steven H. Landers
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Home Health Care ◽  
Private Insurance ◽  
Health Agency ◽  
Home Health ◽  
Care Utilization ◽  
Observational Cohort ◽  
Racial Ethnic ◽  
Retrospective Observational Cohort Study

COVID-19 patients represent a new and distinct population in home health care. Little is known about health care utilization and incremental improvements in health for recovering COVID-19 patients after admission to home health care. Using a retrospective observational cohort study of 5452 episodes of home health care admitted to a New Jersey Home Health Agency between March 15 and May 31, 2020, this study describes COVID-19 Home Health Care (HHC) patients ( n = 842) and compare them to the general HHC population ( n = 4610). COVID HHC patients differ in significant ways from the typical HHC population. COVID patients were more likely to be 65 years of age and younger (41% vs 26%), be from a racial/ethnic minority (60% vs 31%), live with another person (85% vs 76%), have private insurance (28% vs 16%), and began HHC with greater independence in activities-of-daily-living (ADL/IADLs). COVID patients received fewer overall visits than their non-COVID counterparts (11.7 vs 16.3), although they had significantly more remote visits (1.7 vs 0.3). Multivariate analyses show that COVID patients early in the pandemic were 34% (CI, 28%-40%) less likely to be hospitalized and demonstrated significantly greater improvement in all the outcome measures examined compared to the general home health population.

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