Table 3.
First Stage
| Outcome: | Hospitalization Level Penetration | County Level Penetration | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| IV: | Payment | Payment * Year |
Simulated County Benchmk |
Simulated State Benchmk |
Payment | Payment * Year |
Simulated County Benchmk |
Simulated State Benchmk |
Payment | Payment * Year |
Simulated County Benchmk |
Simulated State Benchmk |
| Payment | .032913*** | .0474*** | .0523*** | .189*** | .032913*** | .0474*** | 0.0523*** | .189*** | .0334*** | .045*** | .0506*** | .1405*** |
| (.0112644) | (.0170) | (.0142) | (.002) | (0.00544) | (.0067) | (0.00773) | (0.0173) | (.0107) | (.0125) | (.0129) | (.0232) | |
| Covariates | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
| Hosp FEs County |
Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | No | No | No | No |
| Fes | No | No | No | No | No | No | No | No | Yes | Yes | Yes | Yes |
| Year FEs | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
| Cluster | County | County | County | County | Hospital | Hospital | Hospital | Hospital | County | County | County | County |
| Obs | 13,678,534 | 13,678,534 | 13,678,534 | 13,678,534 | 13,678,534 | 13,678,534 | 13,678,534 | 13,678,534 | 2,376 | 2,376 | 2,376 | 2376 |
| R-squared F-stat | .4825 8.54 | .51 4.03 | .4614 13.66 | .51 24.51 | .4825 36.66 | .51 22.2 | .4614 45.85 | .51 119.5 | .445 9.7 | .465 4.9 | .465 15.3 | .4921 36.6 |
Note: Dependent variable is MA Managed Care penetration, defined as MA HMO penetration + MA PPO penetration, with units in percentages. Individual level covariates are age, sex, race, and type of insurance. Hospital level covariates are teaching hospital status, for-profit status, and number of beds. County level covariates are population size, % in poverty, % unemployed, per capita income, % male, % white, % black, % Hispanic, % pop under 15, % aged 15–19, % aged 20–20, % aged 25–44, % aged 45–64, % aged 65 and older, # of general practitioners per capita, # of specialists per capita, # of surgeons per capita, # of other physicians per capita. Robust standard errors in parentheses (clustered on county).
p<0.01,
p<0.05,
p<0.1.
Data are from Healthcare Cost and Utilization Project’s state inpatient database for NY, MA, AZ, FL, and CA (20% sample) for 1999–2009 and from the Medicare enrollment files for 1998–2009. The “payment*year” column aggregates the year-specific coefficients to show a comparable average.