We compare healthcare spending in public and private Medicare using newly available claims data from Medicare Advantage (MA) insurers. MA insurer revenues are 30 percent higher than their healthcare spending. Adjusting for enrollee mix, healthcare spending per enrollee in MA is 9 to 30 percent lower than in traditional Medicare (TM), depending on the way we define "comparable" enrollees. Spending differences primarily reflect differences in healthcare utilization, with similar reductions for "high value" and "low value" care, rather than healthcare prices. We present evidence consistent with MA plans encouraging substitution to less expensive care and engaging in utilization management. (JEL H11, H42, H51, I11, I13).

中文翻译：

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公共和私人医疗保险中的医疗保健支出和利用


我们使用 Medicare Advantage (MA) 保险公司最新提供的索赔数据来比较公共和私人 Medicare 的医疗保健支出。马萨诸塞州保险公司的收入比其医疗保健支出高出 30%。根据参保者组合进行调整后，MA 中每位参保者的医疗保健支出比传统 Medicare (TM) 低 9% 至 30%，具体取决于我们定义“可比”参保者的方式。支出差异主要反映了医疗保健利用率的差异，“高价值”和“低价值”护理的类似减少，而不是医疗保健价格的减少。我们提供与 MA 计划一致的证据，鼓励替代更便宜的护理并参与利用管理。 （JEL H11、H42、H51、I11、I13）。