ISPS Health Center Seminar: Jonathan Skinner (Dartmouth) “The Benefits of Medicare Spending”

“The Benefits of Medicare Spending:  Evidence from the Healthcare Cost Slowdown”

Paper co-authored with Amitabh Chandra (Kennedy School of Government, Harvard) and Carrie Colla (Dartmouth)

Abstract:  What is the health consequence of an incremental Medicare dollar? Studies have demonstrated a wide range of estimates, with some showing a positive association between spending and health outcomes, and others showing a negative association. We develop a model of productive and allocative efficiency, and test it using a dataset of 880,000 Medicare enrollees (both tourists and non-tourists) admitted to hospital with a heart attack, or acute myocardial infarction, between 2007-11.  We match these data with hospital-year data on treatments ranging from those with documented effectiveness (e.g., beta blocker and statin use, primary stenting) to those associated with high spending and no impact on outcomes (e.g., home health care predictive of fraud). We explain a large fraction of hospital-level variability in both survival, and Medicare spending, solely by differences in hospital input choices, whether across hospitals or over time.

Bio: Jonathan Skinner is the James O. Freedman Presidential Professor in Economics at Dartmouth College and a professor at the Geisel School of Medicine’s Institute for Health Policy and Clinical Practice. A member of the National Academy of Medicine (formerly the IOM), he is an associate editor of the American Economic Journal: Economic Policy, and a former editor of the Journal of Human Resources. Skinner received his M.A. and Ph.D. in Economics from UCLA, and a B.A. in political science and economics from the University of Rochester. He has also taught at the University of Virginia, the University of Washington, Stanford University, and Harvard University.