The Impact of Increased Cost-Sharing on Utilization of Low Value Services: Evidence from the State of Oregon

51 Pages Posted: 5 Dec 2016 Last revised: 4 Jul 2021

See all articles by Jonathan Gruber

Jonathan Gruber

Massachusetts Institute of Technology (MIT) - Department of Economics; National Bureau of Economic Research (NBER)

Catherine Maclean

Temple University

Bill Wright

Providence Health & Services - Center for Outcomes Research and Education

Eric Wilkinson

Temple University

Kevin Volpp

University of Pennsylvania - Perelman School of Medicine, Department of Medicine

Multiple version iconThere are 2 versions of this paper

Date Written: December 2016

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.

Suggested Citation

Gruber, Jonathan and Maclean, Catherine and Wright, Bill and Wilkinson, Eric and Volpp, Kevin, The Impact of Increased Cost-Sharing on Utilization of Low Value Services: Evidence from the State of Oregon (December 2016). NBER Working Paper No. w22875, Available at SSRN: https://ssrn.com/abstract=2880314

Jonathan Gruber (Contact Author)

Massachusetts Institute of Technology (MIT) - Department of Economics ( email )

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National Bureau of Economic Research (NBER)

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Catherine Maclean

Temple University ( email )

Philadelphia, PA 19122
United States

Bill Wright

Providence Health & Services - Center for Outcomes Research and Education ( email )

United States

Eric Wilkinson

Temple University ( email )

Kevin Volpp

University of Pennsylvania - Perelman School of Medicine, Department of Medicine ( email )

Philadelphia, PA 19104
United States

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