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Katherine Baicker

Matthew Niedzwiecki, Katherine Baicker, Michael Wilson, David M Cutler, Ziad Obermeyer
BACKGROUND: There is substantial interest in identifying low-acuity visits to emergency departments (EDs) that could be treated more appropriately in other settings. Systematic differences in illness severity between ED patients and comparable patients elsewhere could make such strategies unsafe, but little evidence exists to guide policy makers. OBJECTIVE: To compare illness severity between patients visiting EDs and outpatient clinics, by comparing short-term mortality and hospitalization, controlling for patient demographics, comorbidity, and visit acuity...
May 2016: Medical Care
Katherine Baicker, Bill J Wright, Nicole A Olson
There is ongoing policy debate about the potential for malpractice liability reform to reduce the use of defensive medicine and slow the growth of health care spending. The effectiveness of such policy levers hinges on the degree to which physicians respond to liability pressures by prescribing medically unnecessary care. Many estimates of this relationship are based on physician reports. We present new survey evidence on physician assessment of their own use of medically unnecessary care in response to medical liability and other pressures, including a randomized evaluation of the sensitivity of those responses to survey framing...
December 2015: Journal of Health Politics, Policy and Law
Benjamin D Sommers, Sharon K Long, Katherine Baicker
No abstract text is available yet for this article.
May 5, 2015: Annals of Internal Medicine
Katherine Baicker, Amitabh Chandra
No abstract text is available yet for this article.
July 2015: JAMA Internal Medicine
Katherine Baicker, Helen Levy
No abstract text is available yet for this article.
March 2015: JAMA Internal Medicine
Katherine Baicker, Helen Levy
No abstract text is available yet for this article.
March 2015: JAMA Internal Medicine
Katherine Baicker, Amy Finkelstein, Jae Song, Sarah Taubman
No abstract text is available yet for this article.
May 2014: American Economic Review
Benjamin D Sommers, Sharon K Long, Katherine Baicker
BACKGROUND: The Massachusetts 2006 health care reform has been called a model for the Affordable Care Act. The law attained near-universal insurance coverage and increased access to care. Its effect on population health is less clear. OBJECTIVE: To determine whether the Massachusetts reform was associated with changes in all-cause mortality and mortality from causes amenable to health care. DESIGN: Comparison of mortality rates before and after reform in Massachusetts versus a control group with similar demographics and economic conditions...
May 6, 2014: Annals of Internal Medicine
Heidi Allen, Bill J Wright, Katherine Baicker
Medicaid expansions will soon cover millions of new enrollees, but insurance alone may not ensure that they receive high-quality care. This study examines health care interactions and the health perceptions of an Oregon cohort three years after they gained Medicaid coverage. During in-depth qualitative interviews, 120 enrollees reported a wide range of interactions with the health care system. Forty percent of the new enrollees sought care infrequently because they were confused about coverage, faced access barriers, had bad interactions with providers, or felt that care was unnecessary...
February 2014: Health Affairs
Sarah L Taubman, Heidi L Allen, Bill J Wright, Katherine Baicker, Amy N Finkelstein
In 2008, Oregon initiated a limited expansion of a Medicaid program for uninsured, low-income adults, drawing names from a waiting list by lottery. This lottery created a rare opportunity to study the effects of Medicaid coverage by using a randomized controlled design. By using the randomization provided by the lottery and emergency-department records from Portland-area hospitals, we studied the emergency department use of about 25,000 lottery participants over about 18 months after the lottery. We found that Medicaid coverage significantly increases overall emergency use by 0...
January 17, 2014: Science
Katherine Baicker, Michael E Chernew, Jacob A Robbins
More than a quarter of Medicare beneficiaries are enrolled in Medicare Advantage, which was created in large part to improve the efficiency of health care delivery by promoting competition among private managed care plans. This paper explores the spillover effects of the Medicare Advantage program on the traditional Medicare program and other patients, taking advantage of changes in Medicare Advantage payment policy to isolate exogenous increases in Medicare Advantage enrollment and trace out the effects of greater managed care penetration on hospital utilization and spending throughout the health care system...
December 2013: Journal of Health Economics
Yuting Zhang, Joseph P Newhouse, Katherine Baicker
No abstract text is available yet for this article.
May 2011: American Economic Review
Heidi Allen, Katherine Baicker, Sarah Taubman, Bill Wright, Amy Finkelstein
In 2008 Oregon allocated access to its Medicaid expansion program, Oregon Health Plan Standard, by drawing names from a waiting list by lottery. The lottery was chosen by policy makers and stakeholders as the preferred way to allocate limited resources. At the same time, it also gave rise to the Oregon Health Insurance Experiment: an unprecedented opportunity to do a randomized evaluation - the gold standard in medical and scientific research - of the impact of expanding Medicaid. In this article we provide historical context for Oregon's decision to conduct a lottery, discuss the importance of randomized controlled designs for policy evaluation, and describe some of the practical challenges in successfully capitalizing on the research opportunity presented by the Oregon lottery through public-academic partnerships...
December 2013: Journal of Health Politics, Policy and Law
Katherine Baicker, Helen Levy
Many current proposals to increase the value of care delivered in the U.S. health care system focus on improved coordination — and with good reason. Badly coordinated care, duplicated efforts, bungled handoffs, and failures to follow up result in too much care for some patients, too little care..
August 29, 2013: New England Journal of Medicine
Katherine Baicker, Mark Shepard, Jonathan Skinner
The US Medicare program consumes an ever-rising share of the federal budget. Although this public spending can produce health and social benefits, raising taxes to finance it comes at the cost of slower economic growth. In this article we describe a model incorporating the benefits of public programs and the cost of tax financing. The model implies that the "one-size-fits-all" Medicare program, with everyone covered by the same insurance policy, will be increasingly difficult to sustain. We show that a Medicare program with guaranteed basic benefits and the option to purchase additional coverage could lead to more unequal health spending but slower growth in taxation, greater overall well-being, and more rapid growth of gross domestic product...
May 2013: Health Affairs
Katherine Baicker, Sarah L Taubman, Heidi L Allen, Mira Bernstein, Jonathan H Gruber, Joseph P Newhouse, Eric C Schneider, Bill J Wright, Alan M Zaslavsky, Amy N Finkelstein
BACKGROUND: Despite the imminent expansion of Medicaid coverage for low-income adults, the effects of expanding coverage are unclear. The 2008 Medicaid expansion in Oregon based on lottery drawings from a waiting list provided an opportunity to evaluate these effects. METHODS: Approximately 2 years after the lottery, we obtained data from 6387 adults who were randomly selected to be able to apply for Medicaid coverage and 5842 adults who were not selected. Measures included blood-pressure, cholesterol, and glycated hemoglobin levels; screening for depression; medication inventories; and self-reported diagnoses, health status, health care utilization, and out-of-pocket spending for such services...
May 2, 2013: New England Journal of Medicine
Amy Finkelstein, Sarah Taubman, Bill Wright, Mira Bernstein, Jonathan Gruber, Joseph P Newhouse, Heidi Allen, Katherine Baicker
In 2008, a group of uninsured low-income adults in Oregon was selected by lottery to be given the chance to apply for Medicaid. This lottery provides an opportunity to gauge the effects of expanding access to public health insurance on the health care use, financial strain, and health of low-income adults using a randomized controlled design. In the year after random assignment, the treatment group selected by the lottery was about 25 percentage points more likely to have insurance than the control group that was not selected...
August 2012: Quarterly Journal of Economics
Katherine Baicker, Helen Levy
Medicare should provide access to care and protection from catastrophic spending while not being so generous that beneficiaries overconsume low-value care, thus driving up costs. Setting cost sharing is a balancing act that the Medicare program doesn't perform very well.
November 8, 2012: New England Journal of Medicine
Yuting Zhang, Seo Hyon Baik, A Mark Fendrick, Katherine Baicker
BACKGROUND: Wide geographic variation in health care spending has generated both concern about inefficiency and policy debate about geographic-based payment reform. Evidence regarding variation has focused on hospital referral regions (HRRs), which incorporate numerous local hospital service areas (HSAs). If there is substantial variation across local areas within HRRs, then policies focusing on HRRs may be poorly targeted. METHODS: Using prescription drug and medical claims data from a 5% random sample of Medicare beneficiaries from 2006 through 2009, we compared variation in health care spending and utilization among 306 HRRs and 3436 HSAs...
November 2012: New England Journal of Medicine
Benjamin D Sommers, Katherine Baicker, Arnold M Epstein
BACKGROUND: Several states have expanded Medicaid eligibility for adults in the past decade, and the Affordable Care Act allows states to expand Medicaid dramatically in 2014. Yet the effect of such changes on adults' health remains unclear. We examined whether Medicaid expansions were associated with changes in mortality and other health-related measures. METHODS: We compared three states that substantially expanded adult Medicaid eligibility since 2000 (New York, Maine, and Arizona) with neighboring states without expansions...
September 13, 2012: New England Journal of Medicine
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