现代产业经济学系列讲座第174期

时　间：2019年5月28日(周二）14:00-15:30

地　点：复旦大学管理学院史带楼501室

主　题：Balance Billing and Health Care Cost: Evidence from Cardiac Stents

主讲人： 陶学臻 上海财经大学商学院 助理教授

主持人：从佳佳 复旦大学管理学院产经系 助理教授

摘　要： Taiwan’s National Health Insurance (NHI) has adopted balance billing for cardiac stents since 2007: NHI covers the full cost of baseline treatment (bare-medal stents); but if a patient prefers more expensive treatments (drug-eluting stents), she must pay for the incremental cost out of pocket. Such “top-up” coverage has been advocated as a good model to provide essential care for the mass population and keep the cost of health care under control (Einav, Finkelstein and Williams, 2016 AEJ Policy). To further reduce health spending, NHI down-adjusted the reimbursement rate of bare-medal stents (to hospitals) in 2009 and 2012. We study how hospitals respond to these changes and how they affect the actual payment from NHI and patients. Based on individual patient records and hospital-reported stent prices (2007-2013), we find no evidence of hospitals increasing the number of stent patients. However, hospitals respond to the rate cuts by increasing the number of stents used per procedure and the price charged for DES. Notably, the increase applies to bare-medal stents but not to drug-eluting stents and recovers 20-40% of revenue loss for BMS models. The higher prices recovered as high as 175% of the revenue loss for DES models.

主讲人简介：陶学臻，上海财经大学商学院助理教授，马里兰大学经济学博士。研究方向包括实证产业组织，量化市场营销等。

 

产业经济学系

2019-5-23