We utilize health care input and output data to evaluate how state-level efficiency in health care has changed in the wake of the Affordable Care Act (ACA). We use a Stochastic Frontier model to estimate annual measures of technical and cost efficiency before, and after, ACA implementation. Results show that following the ACA, states’ technical efficiency scores improved and converged across states. However, cost efficiency scores declined suggesting health outputs rose by a proportionally smaller margin than health care costs. We further investigate efficiency changes for ACA-induced Medicaid expansions. We find Medicaid expansion led to decreased cost efficiency scores, but may have led to increased technical efficiency scores. Overall, results suggest the ACA represents a package of reforms that present a trade-off between technical and cost efficiency.

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负担得起的护理行为是否影响了卫生保健效率？

我们利用医疗保健的输入和输出数据来评估《平价医疗法案》（ACA）之后州级医疗保健效率的变化。我们使用随机边界模型来估算ACA实施前后的年度技术和成本效率指标。结果表明，遵循ACA，各州的技术效率得分提高并趋同。但是，成本效率得分下降表明，卫生产出的增长幅度要比卫生保健费用的增长幅度小。我们进一步调查了ACA诱导的医疗补助扩展的效率变化。我们发现医疗补助计划的扩张导致成本效率得分降低，但可能导致技术效率得分上升。总体，