Ana Aizcorbe - Academia.edu (original) (raw)

Papers by Ana Aizcorbe

Cost of illness (COI) studies focus on allocating health expenditures to a comprehensive set of d... more Cost of illness (COI) studies focus on allocating health expenditures to a comprehensive set of diseases. A variety of techniques have been used to allocate spending to diseases. In this paper, we compare spending attributed to diseases using three approaches: one based on the principal diagnosis listed on each encounter’s claim, a second based on all diagnoses listed on the encounter, and a third based on decomposing a person’s total annual spending to their conditions. The study sample is large: 2.3 million commercially insured individuals under age 65. Results indicate significant differences in the allocations from the different approaches. The two claims-based encounter approaches allocate 78% of overall spending to diseases, while the person approach allocates 95% of spending to diseases. The large unallocated spending in the claims-based approach is due largely to lack of diagnosis codes for prescription medications. Spending was concentrated in a small number of conditions; ...

Industrial Organization, Mar 8, 2005

point, which translates into an overstatement of overall inflation of .2 percentage point and an ... more point, which translates into an overstatement of overall inflation of .2 percentage point and an understatement of GDP growth of the same amount. We also find that an adjustment recently used in Bradley et al provides a useful approximation to the indexes advocated by health economists.

Statistical journal of the IAOS

As the core nationally representative health expenditure survey in the United States, the Medical... more As the core nationally representative health expenditure survey in the United States, the Medical Expenditure Panel Survey (MEPS) is increasingly being used by statistical agencies to track expenditures by disease. However, while MEPS provides a wealth of data, its small sample size precludes examination of spending on all but the most prevalent health conditions. To overcome this issue, statistical agencies have turned to other public data sources, such as Medicare and Medicaid claims data, when available. No comparable publicly available data exist for those with employer-sponsored insurance. While large proprietary claims databases may be an option, the relative accuracy of their spending estimates is not known. This study compared MEPS and MarketScan estimates of annual per person health care spending on individuals with employer-sponsored insurance coverage. Both total spending and the distribution of annual per person spending differed across the two data sources, with MEPS es...

The groupers varied in their ability to allocate spending to episodes: MEG allocated 82% and ETG ... more The groupers varied in their ability to allocate spending to episodes: MEG allocated 82% and ETG allocated 86% of spending to episodes. Of episodes ending in 2006, MEG classified 69% (corresponding to 53% of costs) as acute, 21% of episodes (43% of costs) as chronic, and the remainder as preventive or administrative. In contrast, ETG classified 54% of episodes (corresponding to 39% of costs) as acute, 36% of episodes (59% of costs) as chronic, and the remainder as preventive or administrative. Five percent of MEGS and 6% of ETGs accounted for half of each grouper's allocated spending. The 25 most expensive episodes accounted for 49% and 46% of total spending on ETGs and MEGs, respectively. Comparative application of the two most widely used episode groupers to the same commercial claims data shows important differences between the two approaches. As the use of episode-based payment expands, payers should be aware that differences between groupers may affect the allocation of spending to episodes, as well as episode classification, thereby impacting the services and providers that are assigned to an episode.

Health affairs (Project Hope), 2014

Researchers have disagreed about factors driving up health care spending since the 1980s. One cam... more Researchers have disagreed about factors driving up health care spending since the 1980s. One camp, led by Kenneth Thorpe, identifies rising numbers of people being treated for chronic diseases as a major factor. Charles Roehrig and David Rousseau reach the opposite conclusion: that three-quarters of growth in average spending reflects the rising costs of treating given diseases. We reexamined sources of spending growth using data from four nationally representative surveys. We found that rising costs of treatment accounted for 70 percent of growth in real average health care spending from 1980 to 2006. The contribution of shares of the population treated for given diseases increased in 1997-2006, but even then it accounted for only one-third of spending growth. We highlight the fact that Thorpe's inclusion of population growth as part of disease prevalence explains the appreciable difference in results. An important policy implication is that programs to better manage chronic d...

SSRN Electronic Journal, 2002

SSRN Electronic Journal, 2003

Hedonic techniques were developed to control for quality differences across goods and over time i... more Hedonic techniques were developed to control for quality differences across goods and over time in order to construct constant-quality aggregate price measures. When the available data are a panel of high-frequency data on models whose characteristics are constant over time, matched-model price indexes can also be used to obtain constantquality price measures. We show this by demonstrating that, given data of this type, certain matched-model indexes yield price measures that are numerically close to those obtained using hedonic techniques.

SSRN Electronic Journal, 2010

American Economic Review, 2005

The Scandinavian Journal of Economics, 2005

Dale Jorgenson's Presidential address to the American Economic Association (2001) makes a convinc... more Dale Jorgenson's Presidential address to the American Economic Association (2001) makes a convincing case that accelerated technological change in the production of semiconductors, microprocessors in particular, has driven the recent increased productivity growth in the U.S. economy. But, while semiconductors now figure prominently in accounts of economic growth, Jorgenson points out that there is not a fully satisfactory economic model of the industry that produces them. This paper is our attempt to rise to Jorgenson's challenge. We develop a model of the semiconductor industry and apply it to the sector producing microprocessor chips (MPU's). Our intention is to produce a model that: (i) fits the basic facts about this sector, (ii) explains the link between technological improvements, price declines, and product introductions (see Jorgenson,

Bureau of Economic Analysis Working Paper WP2005 …, 2005

Journal of Health Economics, 2011

The utilization of health care services has undergone several important shifts in recent years th... more The utilization of health care services has undergone several important shifts in recent years that have implications for the cost of medical care. We empirically document the presence of these shifts for a broad list of medical conditions and assess the implications for price indexes. Following the earlier literature, we compare the growth of two price measures: one that tracks expenditures for the services actually provided to treat conditions and another that holds the mix of those services fixed over time. Using retrospective claims data for a sample of commercially-insured patients, we find that, on average, expenditures to treat diseases rose 11% from 2003:1 to 2005:4 and would have risen even faster, 18%, had the mix of services remained fixed at the 2003:1 levels. This suggests that fixed-basket price indexes, as are used in the official statistics, could overstate true price growth significantly.

Communications of the ACM, 2013

Applying a centuries-old technique to modern cost estimation.

Journal of Economic Perspectives, 2017

A key economic indicator is real output. To get this right, we need to measure accurately both th... more A key economic indicator is real output. To get this right, we need to measure accurately both the value of nominal GDP (done by Bureau of Economic Analaysis) and key price indexes (done mostly by Bureau of Labor Statisticcs). All of us have worked on these measurements while at the BLS and the BEA. In this article, we explore some of the thorny statistical and conceptual issues related to measuring a dynamic economy. An often-stated concern is that the national economic accounts miss some of the value of some goods and services arising from the growing digital economy. We agree that measurement problems related to quality changes and new goods have likely caused growth of real output and productivity to be understated. Nevertheless, these measurement issues are far from new, and, based on the magnitude and timing of recent changes, we conclude that it is unlikely that they can account for the pattern of slower growth in recent years. First we discuss how the Bureau of Labor Statist...