Health Insurance, Utilization and Outcomes
This session, titled “Health Insurance, Utilization and Outcomes”, will present evidence from three studies that use natural experiments to identify the causal effect of insurance on utilization and health. The identification of causal effects within this literature is challenging since many unobserved factors are likely to influence both insurance rates and utilization and outcomes. This session provides new insights on important effects of health insurance coverage and design. The first study evaluates changes in hospital reimbursement rates for publicly insured patients in Germany and their impact on treatment volume. This study provides evidence about the influence of insurance on inpatient utilization and explores the role of physician induced demand. It shows that decreases in reimbursement rates result in higher volumes of care for certain procedures, but not for all. The second study estimates the effect of the dependent coverage mandate in the Affordable Care Act on use of outpatient services and spending. It evaluates the responsiveness of individual demand to increased access to insurance coverage and discusses the role of moral hazard. The third study examines the impact of Medicare Part D coverage on depressive symptoms. This study shows that increased access to prescription drug coverage improves mental health and discusses the potentially beneficial role of moral hazard. Together, these three studies show that health insurance coverage can change utilization and health, sometimes in unintended ways.