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Updated: Jul 9, 2025

Inverse Probability of Treatment Weighting Propensity Score using the Military Health System Data Repository and National Death Index
Published on: January 8, 2020
Public and Private Options in Practice: The Military Health System
Michael D Frakes1, Jonathan Gruber2, Timothy Justicz3
1Duke University and National Bureau of Economic Research, 210 Science Drive, PO Box 90362, Durham, NC 27708.
Abstract:
Recent debates over health care reform, including in the context of the Military Health System (MHS) and Veterans Administration, highlight the dispute between public and private provision of health care services. Using novel data on childbirth claims from the MHS and drawing on the combination of plausibly exogenous patient moves and heterogeneity across bases in the availability of base hospitals, we identify the impact of receiving obstetrical care on versus off military bases. We find evidence that off-base care is associated with slightly greater resource intensity, but also notably better outcomes, suggesting marginal efficiency gains from care privatization.
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