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Selection and Causal Effects in Voluntary Programs: Bundled Payments in Medicare / Atul Gupta, Joseph R. Martinez, Amol S. Navathe.
- Format:
- Book
- Author/Creator:
- Gupta, Atul.
- Series:
- Working Paper Series (National Bureau of Economic Research) no. w31256.
- NBER working paper series no. w31256
- Language:
- English
- Physical Description:
- 1 online resource: illustrations (black and white);
- Place of Publication:
- Cambridge, Mass. National Bureau of Economic Research 2023.
- Summary:
- Voluntary participation is a central feature of reforms being tested across US healthcare. Allowing choice can enhance effects if participants sort on unobserved treatment gains. However, selection may also bias program evaluation, misleading policymakers. We study this trade-off in the case of a national reform to reduce spending on surgeries. We exploit variation due to idiosyncratic program rules to instrument for participation. We detect considerable treatment effect heterogeneity but no evidence for sorting on treatment gains. In contrast, there is substantial selection on untreated outcomes in an unexpected direction, leading the difference in differences estimator to understate the causal effect.
- Notes:
- Print version record
- May 2023.
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