TY  - RPRT
        AU  - Gruber, Jonathan
AU  - Maclean, J. Catherine
AU  - Wright, Bill
AU  - Wilkinson, Eric
AU  - Volpp, Kevin G.
        TI  - The Impact of Increased Cost-Sharing on Utilization of Low Value Services: Evidence from the State of Oregon
        PY  - 2017/Jan/
        PB  - Institute of Labor Economics (IZA)
        CY  - Bonn
        T2  - IZA Discussion Paper
        IS  - 10477
        UR  - https://www.iza.org/publications/dp10477
        AB  - 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.
        KW  - value-based insurance design
KW  - low value
KW  - healthcare
KW  - cost-sharing
        ER  -