Laurence Baker Assistant Professor in the Department of Health Research and Policy Stanford University

Abstract:
During the course of the 1990s, California significantly expanded the role of managed care in its Medicaid program. We exploit variations in the timing of implementation across counties to examine the impact managed care implementation had on spending and on health care use and outcomes for pregnant mothers and newborns. We find that the adoption of the program did not reduce spending, and may have increased it. Adoption of managed care is associated with noticeable changes in health care utilization, including changes in prenatal care use, hospital stays, use of “intensive” birth procedures like induction, and access to high-level NICUs for low birthweight newborns. Evidence on outcome impacts is mixed, with evidence suggesting better outcomes for some infants and worse for others.

Biosketch:
Laurence Baker, Ph.D. is Associate Professor of Health Research and Policy (with tenure) and Chief of Health Services Research at the Stanford University School of Medicine, Fellow of the Center for Health Policy at Stanford University, and Research Associate in the Health Care and Productivity programs of the National Bureau of Economic Research in Cambridge, MA. Dr. Baker also holds a courtesy appointment in the Stanford University Department of Economics. Dr. Baker received his M.A. and Ph.D. in Economics from Princeton University in 1994, and his B.A. from Calvin College in Grand Rapids, Michigan in 1990. Before coming to Stanford, he was a Research Economist at the Robert Wood Johnson Foundation and, briefly, a volunteer consultant to the White House Task Force on Health Reform. He was awarded the Alice S. Hersh Young Investigator Award by the Academy for Health Services Research and Health Policy in 2000. In 1997 and 1999 he received the National Institute for Health Care Management’s research prize for his work on managed care. He serves on the editorial boards of Health Services Research and Medical Care Research and Review.

His main research interests are in the area of health economics, particularly the effects of managed care on the structure and functioning of the health care system, and he has written numerous journal articles and book chapters in this area. Other areas of research include the effects of managed care on physician satisfaction, the economics of emergency health care delivery, the effects of the internet on health care, and the dynamics of the physician labor market.