@TechReport{iza:izadps:dp10477,
            	author={Gruber, Jonathan and Maclean, J. Catherine and Wright, Bill and Wilkinson, Eric and Volpp, Kevin G.},
            	title={The Impact of Increased Cost-Sharing on Utilization of Low Value Services: Evidence from the State of Oregon},
            	year={2017},
	month={Jan},
            	institution={Institute of Labor Economics (IZA)},
            	address={Bonn},
            	type={IZA Discussion Paper},
            	number={10477},
            	url={https://www.iza.org/publications/dp10477},
	abstract={In this study we examine the impact of a value-based insurance design (V-BID) program implemented between 2010 and 2013 at a large public employer in the state of Oregon. The program substantially increased cost-sharing, specifically copayments and coinsurance, for several healthcare services believed to be of low value and overused (sleep studies, endoscopies, advanced imaging, and surgeries). Using a differences-in-differences design coupled with granular, administrative health insurance claims data, we estimate the change in low value healthcare service utilization among beneficiaries before and after program implementation relative to a comparison group of beneficiaries who were not exposed to the V-BID. Our findings suggest that the V-BID significantly reduced utilization of targeted services. These findings have important implications for both public and private healthcare policies as V-BID principles are rapidly proliferating in healthcare markets.},
	keywords={value-based insurance design;low value;healthcare;cost-sharing},
            }