Hospital Quality and Selective Contracting: Evidence from Kidney Transplantation

摘要

Most private health insurers offer a limited network of providers to enrollees. Critics havenquestioned whether selective contracting benefits patients. Plans counter that they take qualityninto account when choosing providers. Using data on five plans’ networks for kidney transplantnhospitals, this study shows that in-network hospitals have better outcomes than out-of-networknfacilities. Conditional logit estimates using patient level data confirm this result: compared tonMedicare patients, privately-insured patients are more likely to register at hospitals with highernsurvival rates. Restricting choice has the potential to improve patient welfare if plans steer uninformednpatients to high quality hospitals and physicians.