Hospitals, Physicians, and Insurance Decisions

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# Hospitals, Physicians, and Insurance Decisions
## Ian McCarthy
### Quick look at some of my research
### June 15, 2021

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# Health care in the U.S.

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# Outline of talk

1. [Background](#background)
2. [Health Insurance Choice](#insurance)
3. [Vertical Integration](#integration)
4. [Physician Learning and Referrals](#referrals)

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# Personal background

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# Background

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  - From Howe, TX
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  ![](images/howe-main-street.png)
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# Background

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  - From Howe, TX
  - Undergrad at the University of North Texas
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# Background

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  - From Howe, TX
  - Undergrad at the University of North Texas
  - PhD at Indiana University
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# Background

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  - From Howe, TX
  - Undergrad at the University of North Texas
  - PhD at Indiana University
  - FTI Consulting, Dallas, TX
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# Background

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  - From Howe, TX
  - Undergrad at the University of North Texas
  - PhD at Indiana University
  - FTI Consulting, Dallas, TX
  - Baylor Scott and White Health Care, Dallas, TX
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# Background

.pull-left[
  - From Howe, TX
  - Undergrad at the University of North Texas
  - PhD at Indiana University
  - FTI Consulting, Dallas, TX
  - Baylor Scott and White Health Care, Dallas, TX
  - Emory University
]

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  ![](images/emory.jpg)
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# Health insurance

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# Decision making

- [Search Costs and Medicare Plan Choice](https://onlinelibrary.wiley.com/doi/abs/10.1002/hec.1539), **Health Economics**, 2010
- [Decision Assistance and Steering in the ACA Exchanges](https://imccart.github.io/ACA-Decision-Support/), Working Project

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# Quality disclosure

- [The Star Treatment: Estimating the Impact of Star Ratings on Medicare Advantage Enrollments](http://jhr.uwpress.org/content/50/4/980.abstract), **Journal of Human Resources**, 2015
- [Supply-side Responses to Public Quality Ratings: Evidence from Medicare Advantage](https://www.journals.uchicago.edu/doi/abs/10.1162/AJHE_a_00070), **American Journal of Health Economics**, 2017
- [Quality Disclosure and the Timing of Insurers' Adjustments: Evidence from Medicare Advantage](https://www.sciencedirect.com/science/article/pii/S0167629617310433), **Journal of Health Economics**, 2018

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# Competition

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# Competition

[Multimarket contact in health insurance: Evidence from Medicare Advantage](https://www.nber.org/papers/w24486), revise and resubmit at **Journal of Industrial Economics**

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# Vertical integration

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# Sources and effects of VI

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# Sources and effects of VI

[Hospital Pricing Following Integration with Physician Practices](https://www.sciencedirect.com/science/article/pii/S0167629621000291), **Journal of Health Economics**, 2021

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# Sources and effects of VI

[Owning the Agent: Hospital Influence on Physician Behaviors](https://www.nber.org/papers/w28859), Working Paper

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Integration and payments:

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Integration and claims:

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# Physician referrals

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# Physician referrals

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# Physician referrals

1. Do PCPs learn about specialist quality and update referral patterns accordingly?
2. Can we improve this learning process? How?

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# Hospital pricing

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# Pricing and pay for performance

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# Pricing and specialization

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