PDF(Pubmed)
Abstract：
This paper examines the tradeoffs of monitoring for wasteful public spending. By penalizing unnecessary spending, monitoring improves the quality of public expenditure and incentivizes firms to invest in compliance technology. I study a large Medicare program that monitored for unnecessary healthcare spending and consider its effect on government savings, provider behavior, and patient health. Every dollar Medicare spent on monitoring generated $24-29 in government savings. The majority of savings stem from the deterrence of future care, rather than reclaimed payments from prior care. I do not find evidence that the health of the marginal patient is harmed, indicating that monitoring primarily deters low-value care. Monitoring does increase provider administrative costs, but these costs are mostly incurred upfront and include investments in technology to assess the medical necessity of care.
摘要：
本文研究了监督浪费性公共支出的权衡。通过惩罚不必要的支出，监控提高了公共支出的质量，并激励公司投资于合规技术。我研究了一项大型医疗保险计划，该计划监控了不必要的医疗保健支出，并考虑了其对政府储蓄的影响，提供者行为，和病人的健康。医疗保险在监测上花费的每一美元都会产生24-29美元的政府储蓄。大部分储蓄来自未来护理的威慑，而不是从先前的护理中收回付款。我没有发现边缘患者的健康受到损害的证据，表明监测主要阻止低价值护理。监控确实增加了提供商的管理成本，但这些费用大多是前期发生的，包括评估医疗护理必要性的技术投资。
