The Benefits to Taxpayers from Increases in Students - RAND ...

104 The Benefits to Taxpayers from Increases in Students’ Educational Attainment
Medicaid
The SIPP does not report Medicaid payments on behalf of a respondent. For each
respondent, it reports whether the respondent was covered by Medicaid, the number
of medical provider visits in the previous 12 months, and whether the respondent was
hospitalized in the previous 12 months. We use a two-part model to estimate benefits
from the Medicaid program. The first part estimates Medicaid utilization, the probability
that a respondent covered by Medicaid had at least one medical provider visit
in the previous 12 months. The second part estimates hospitalization, conditional on
Medicaid utilization. We assume that Medicaid utilization absent hospitalization is
outpatient utilization. We assume that hospitalization is inpatient utilization.
As the SIPP provides utilization but not benefit data, we compute per-person
average inpatient as well as outpatient benefits from Centers for Medicare and Medicaid
Services data.
As our analysis of the age profile of Medicaid participants and nonparticipants
did not indicate anything remotely resembling a transition point based on age, we did
not separately model Medicaid utilization for the elderly and non-elderly. Estimates are
presented in Table C.5.
Medicare
The SIPP does not report Medicare payments on behalf of a respondent. For each
respondent, it reports whether the respondent was covered by Medicare, the number
of medical provider visits in the previous 12 months, and whether the respondent was
hospitalized in the previous 12 months. We use a two-part model to estimate benefits
from the Medicare program. The first part estimates Medicare utilization, the probability
that a respondent covered by Medicare had at least one medical provider visit
in the previous 12 months. The second part estimates hospitalization, conditional on
Medicare utilization. We assume that Medicare utilization absent hospitalization is
outpatient utilization. We assume that hospitalization is inpatient utilization.
As the SIPP provides utilization but not benefit data, we compute per-person
average inpatient as well as outpatient benefits from CMS data.
As Medicare is primarily a health care insurance program for the elderly but also
a disability and renal-disease program regardless of age, we modeled Medicare utilization
separately for the elderly and non-elderly. An analysis of the age distribution of
participants and nonparticipants also supports this choice for mere utilization (not
hospitalization). Estimates are presented in Table C.6.