June 21, 2016
Timothy Layton, whose research focuses largely on managed care and Medicaid and Medicare, first came to HCP in 2012 as a graduate student research assistant. Just a few short years later, as of June 2016, he begins his new appointment as an assistant professor of health care policy.
Layton, who received his BA in economics and political science from Brigham Young University and his PhD in economics from Boston University, came to HCP initially as a student to work with Thomas McGuire and stayed on as a post-doc.
As a graduate student, Layton became interested in the field of health economics because of the wealth of data available enabling empirical study and development of possible solutions to difficult policy problems. It also, according to Layton, had a lot of interesting examples of market failures that allow for study to avoid replicating them in the future.
Given this interest, Layton’s current focus on Medicaid is somewhat ironic, because in the past there has not been much reliable data available to researchers for studying questions related to efficiency and quality of care in state Medicaid programs.
Layton says, “Economists have done a reasonably good job figuring out the economics of more conventional health insurance markets like the state and federal Health Insurance Marketplaces and the Medicare Advantage program. Medicaid Managed Care markets, however, are a different animal, and it’s important to understand whether policies that have been implemented in the Marketplaces or in Medicare Advantage will also work under the vastly different market conditions present in Medicaid Managed Care.”
Today, over 70% of Medicaid recipients are enrolled in a private managed care plan, and some states now have relatively high quality data for enrollment and health care utilization patterns of these managed care enrollees. This presents a number of opportunities to study how a market with no premiums and limited patient choice of plans might respond differently to a system of “managed competition,” which is usually driven by competition between insurance companies to provide high quality health plans.
Layton is currently working with data from the Medicaid program in the state of New York as well as establishing new relationships with MassHealth in Massachusetts and MO Health Net, Missouri’s Medicaid program, to begin obtaining accurate data. This will allow for rigorous study of the consequences of the wide range of regulations available to policymakers.
Layton says, “Thus far, the states we have talked with have been very interested in the work we are doing, providing us with data and helping us to understand the questions that are most important to them at this time. We hope to build many relationships with state Medicaid programs and to become a resource for them to go to when they need to understand the peculiar economics of Medicaid and when they want to know which policies and regulations might be right for their program.”
Ultimately, the goal is to develop a body of work to help state Medicaid directors to design their managed care programs to provide the best care at the best price. Layton says this challenge is particularly important because of how vulnerable the Medicaid population is, and this sense of urgency helps to drive his work.
Layton has also worked on more conceptual questions about how health care markets work and how to incentivize companies to provide efficient care at low prices. A recent paper that he worked on with McGuire laid out how marketplace formulas do not pay insurance companies sufficiently for covering patients with mental disorders.
“At HCP, there is a really strong focus on trying to make an impact, so we restrict our research to what policymakers might actually do,” he says. “It is a big part of the reason I have stayed here—for the immense impact I can have through HCP, and the amazing team that I can work with as equal partners.”
He adds, “It is shocking and humbling to me that I am here. It means my career will be a lot more meaningful and impactful than it would otherwise be. I have the ability to research what I want, and the work I do will have a much better chance of having a concrete effect.”