1. Does the Implementation of Reference Pricing Result in Reduced Utilization? Evidence From Inpatient and Outpatient Procedures.
- Author
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Elser, Holly, Lin, Wei, Catalano, Ralph A., and Brown, Timothy T.
- Subjects
REFERENCE pricing ,BOX-Jenkins forecasting ,ARTHROSCOPY ,AMBULATORY surgery ,KNEE surgery ,TIME series analysis ,CATARACT surgery - Abstract
Reference pricing (RP) is an insurance design that can be used to incentivize patients to use low-price settings. While RP is not intended to affect overall utilization, it could unintentionally reduce utilization. We examined whether utilization was reduced when a large employer adopted RP for selected elective surgeries, including inpatient joint replacement surgery and outpatient cataract surgery, colonoscopy, and arthroscopic surgery. Data included a treatment group subject to RP implementation and a comparison group that was not. We applied autoregressive integrated moving average analysis as comparison-population interrupted time-series analysis to determine whether there were procedure reductions following RP implementation. We find no evidence of short-term decreases (within 3 months of RP implementation). However, we find very modest declines of approximately 14 (20%) fewer arthroscopic knee surgeries 6 months after RP implementation and 129 (17.2%) fewer colonoscopies 8 months after RP implementation. There were no declines in the other procedures examined. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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