Download or read book Essays on Contracts in Health Insurance written by Ilya Rahkovsky and published by . This book was released on 2010 with total page 176 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Essay on Contracts in Health Insurance written by Ilya Rahkovsky and published by . This book was released on 2010 with total page 75 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Essays on Physician Contracts Health and Unemployment and Long term Care Insurance written by Hideki Ariizumi and published by . This book was released on 2005 with total page 262 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Essays on Health Insurance Plan Design written by Chenyuan Liu and published by . This book was released on 2020 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Health care markets have great economic importance and represent a large share of GDP in the U.S. Health insurance plans play a key role in the efficiency of these markets. My dissertation studies the design of health insurance contracts and how they affect market efficiency. Chapter 1 of my dissertation the prevalence of financially dominated options in health plan menus. We analyze Kaiser Family Foundation data on health plans that firms offer to their employees. For firms offering both a high-deductible and lower-deductible health plan, 62 percent of the time the high-deductible option has lower maximum spending risk for the employee. We estimate that the high-deductible plan dominates at roughly half of firms. We identify adverse-selection pricing as a likely mechanism for these surprising patterns and discuss implications for our understanding of the value of plan choice in employer-sponsored health insurance. Chapter 2 of my dissertation identifies both theoretically and empirically a new channel of sorting in insurance markets under asymmetric information: sorting by plan design. A model allowing for rich contract designs predicts high-risk individuals will sort into risk-minimizing straight-deductible plans, while lower-risk individuals prefer plans that trade higher maximum expenditure risk for coverage against small losses. Analyzing data from the ACA Exchange, I find that within coverage tiers, plans vary significantly along multi-dimensional cost-sharing attributes. Further, straight-deductible plans attract higher-risk enrollees than other designs as the model predicts. I discuss how these insights can inform discussions around the standardization of insurance plans. Chapter 3 of my dissertation studies the effects of capitated payment models on physicians' treatment decisions in the treatment of lower back pain in the U.S. We use a large employer-sponsored health insurance claim database from 2003 to 2006, and leverage capitation variation within the plan and physician to mitigate selection concerns. We find that the treatment intensity of capitated patients is 5 to 10 percent lower than otherwise similar non-capitated patients, mainly from therapy, diagnostic testing, and drugs. We also find no evidence of increased readmission rates for capitated patients.
Download or read book Essays on Health Insurance Markets written by Kevin David Frick and published by . This book was released on 1996 with total page 368 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Essays on Insurance and Taxation written by Marika Ilona Cabral and published by Stanford University. This book was released on 2011 with total page 290 pages. Available in PDF, EPUB and Kindle. Book excerpt: This dissertation consists of four distinct essays. In an essay entitled "Claim Timing and Ex Post Adverse Selection: Evidence from Dental 'Insurance, ' " I explore the impact of strategic timing on insurance market allocations. If people can delay a claim just long enough to buy more insurance coverage in anticipation of it, severe adverse selection may result, and in extreme cases, this can lead to the complete unraveling of an insurance market. I study these forces by analyzing dental treatments and insurance, with the goal of understanding insurance in the market for dental care and also revealing lessons that apply to insurance markets more broadly. Using rich claim-level data from a large firm, my analysis reveals that the strategic delay of treatment and the associated adverse selection may be an important factor in explaining why so few people have dental coverage in the US and why typical dental "insurance" contracts provide so little insurance. More generally, my results suggest that insurance products without contract features designed to limit coverage for strategically delayed costs (e.g., open-enrollment periods, pricing pre-existing conditions) may generate unraveling. An essay entitled "The Hated Property Tax: Salience, Tax Rates, and Tax Revolts" (with Caroline Hoxby), explores the relationship between the salience of the property tax and observed property tax rates. We hypothesize that high salience explains the unpopularity of the property tax, the level of the property tax, and prevalence of property tax revolts. To identify variation in the salience of the property tax over local jurisdictions and over time, we exploit conditionally random variation in tax escrow, a method of paying the property tax that makes it much less salient. We find that areas in which the property tax is less salient are areas in which property taxes are higher and property tax revolts are less likely to occur. In an essay entitled "Private Coverage and Public Costs: Identifying the Effect of Private Supplemental Insurance on Medicare Spending" (with Neale Mahoney), we explore the impact of private supplemental insurance on Medicare spending. Private supplemental insurance to "fill the gaps" of Medicare, known as Medigap, is very popular. We estimate the impact of this supplemental insurance on total medical spending using an instrumental variables strategy that leverages discontinuities in Medigap premiums at state boundaries. Our estimates suggest that Medigap increases medical spending by 57 percent---or about 40 percent more than previous estimates suggest. Back-of-the-envelope calculations indicate that a 20 percent tax on premiums would generate combined revenue and savings of 6.2 percent of Medicare baseline costs. An essay entitled "The Effect of Insurance Coverage on Preventive Care" (with Mark Cullen), explores the effect of insurance coverage on preventive care utilization. Using health insurance claims data from a large company, this paper examines the implementation of an insurance benefit design which differentially increased the marginal price of curative care (non-preventive care) while decreasing the marginal price of prevention. We examine the effect of the differential price change on the use of preventive procedures. We reveal evidence consistent with an important negative cross-price effect; that is, increases in the price of curative care can depress preventive care utilization.
Download or read book Medical Work in America written by Eliot Freidson and published by Yale University Press. This book was released on 1989-01-01 with total page 292 pages. Available in PDF, EPUB and Kindle. Book excerpt: Present-day health care policies in the United States are moving toward a system in which patients will be treated like industrial objects by doctors forced to work mechanically, says the distinguished medical sociologist Eliot Freidson in Medical Work in America. He offers a number of controversial proposals designed both to reduce costs and to avoid such dehumanization. In a series of essays that includes some of his classic work as well as significant new material, Freidson discusses the doctor-patient relationship, relations between physicians in various forms of medical practice, and the forces now reorganizing medical work. He shows how increasingly restrictive health insurance contracts insert a new, problematic element into both doctor-patient and colleague relations, and how bureaucratic methods of controlling medical decisions affect those relations. Finally, Freidson advances some basic principles to guide health care policy. He emphasizes that the physician's freedom to exercise discretion is essential if patients are to be treated as individuals rather than as administratively defined diagnostic categories. His recommendations include eliminating fee-for-service compensation, controlling health industry profits, and limiting the external administrative regulation of medical decisions while organizing medical work in such a way as to maximize effective and responsible self-governance.
Download or read book Essays on Medical Quality Measurement and Contract Theory written by Daniel Lawver and published by . This book was released on 2011 with total page 80 pages. Available in PDF, EPUB and Kindle. Book excerpt: This dissertation consists of three essays. The first essay studies quality increases in the medical sector. A large and growing share of income is spent on medical goods and services each year. Existing measures of the price and quantity of medical goods and services do not take changes in quality into account. Ample micro evidence suggests the quality of medical goods and services has, in fact, improved over time. This essay estimates changes in medical quality at the aggregate level. To do so, this essay develops and estimates a dynamic structural model of the demand for medical purchases. The main result of this essay is that the quality of medical goods and services has increased by 2.2 percent per year between 1996 and 2007. One implication is that, after adjusting for changes in medical quality, the relative price of medical goods and services fell by 0.5 percent per year over this period, whereas Bureau of Labor Statistics estimates suggest it rose by 1.6 percent per year. The second essay develops a method to infer the life cycle profile of the quality of medical care in accumulating of health capital and the depreciation rate of health capital. To do so, this essay develops a life cycle model of the demand for medical purchases in which individuals invest in health capital. The use of these methods is illustrated by inferring the life cycle profile of the quality of medical care and the depreciation rate of health capital for 25-84 year old males between 1996 and 2007. The third essay studies implementable outcomes in partnership games. In this setting, it is well known that contracts which satisfy budget balance cannot implement efficient outcomes. Then, it is natural to ask which outcomes can be implemented. This essay characterizes the outcomes of all budget balancing contracts. With standard regularity conditions on production and utility functions, all outcomes which can be implemented by a budget balancing contract can be implemented by a linear contract. This implies that, with respect to welfare, we can consider a compact set of implementable outcomes without loss of generality. The budget-balancing contract whose outcome maximizes welfare, therefore, exists.
Download or read book Essays in the Economics of Health Insurance written by Natalia Serna and published by . This book was released on 2023 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Rising health care costs motivate the use of demand- and supply-side mechanisms to control the consumption of health services, and generate incentives for insurers to engage in risk selection strategies. Using data from the Colombian health care system, I first measure how demand for different health services responds to cost-sharing using a regression discontinuity design. I then study how cost-sharing impacts negotiated service prices between insurers and hospitals using a model of Nash-in-Nash bargaining. Finally, I quantify the impact of risk selection incentives on hospital network breadth using a model of insurer competition in networks. I find that cost-sharing is effective at reducing health care costs, but that consumption reductions happen across necessary and unnecessary services. Counterfactual simulations show that negotiated hospital prices are U-shaped with respect to the coinsurance rate, and minimized at a coinsurance rate of 30 percent. Findings of the model of insurer competition in networks show that insurers engage in risk selection by providing narrow networks. Improving the risk adjustment formula reduces selection incentives and motivates insurers to expand their networks in every health service. Allowing insurers to compete on premiums and networks, shows that price and non-price characteristics of insurance contracts are substitute mechanisms for risk selection.
Download or read book Essays on Complementarities and Innovations Innovations in Labor Contracts Optimal Rising Health Care Costs written by Omar Azfar and published by . This book was released on 1996 with total page 158 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Essays on Insurance and Taxation written by Marika Ilona Cabral and published by . This book was released on 2011 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: This dissertation consists of four distinct essays. In an essay entitled "Claim Timing and Ex Post Adverse Selection: Evidence from Dental 'Insurance, ' " I explore the impact of strategic timing on insurance market allocations. If people can delay a claim just long enough to buy more insurance coverage in anticipation of it, severe adverse selection may result, and in extreme cases, this can lead to the complete unraveling of an insurance market. I study these forces by analyzing dental treatments and insurance, with the goal of understanding insurance in the market for dental care and also revealing lessons that apply to insurance markets more broadly. Using rich claim-level data from a large firm, my analysis reveals that the strategic delay of treatment and the associated adverse selection may be an important factor in explaining why so few people have dental coverage in the US and why typical dental "insurance" contracts provide so little insurance. More generally, my results suggest that insurance products without contract features designed to limit coverage for strategically delayed costs (e.g., open-enrollment periods, pricing pre-existing conditions) may generate unraveling. An essay entitled "The Hated Property Tax: Salience, Tax Rates, and Tax Revolts" (with Caroline Hoxby), explores the relationship between the salience of the property tax and observed property tax rates. We hypothesize that high salience explains the unpopularity of the property tax, the level of the property tax, and prevalence of property tax revolts. To identify variation in the salience of the property tax over local jurisdictions and over time, we exploit conditionally random variation in tax escrow, a method of paying the property tax that makes it much less salient. We find that areas in which the property tax is less salient are areas in which property taxes are higher and property tax revolts are less likely to occur. In an essay entitled "Private Coverage and Public Costs: Identifying the Effect of Private Supplemental Insurance on Medicare Spending" (with Neale Mahoney), we explore the impact of private supplemental insurance on Medicare spending. Private supplemental insurance to "fill the gaps" of Medicare, known as Medigap, is very popular. We estimate the impact of this supplemental insurance on total medical spending using an instrumental variables strategy that leverages discontinuities in Medigap premiums at state boundaries. Our estimates suggest that Medigap increases medical spending by 57 percent--or about 40 percent more than previous estimates suggest. Back-of-the-envelope calculations indicate that a 20 percent tax on premiums would generate combined revenue and savings of 6.2 percent of Medicare baseline costs. An essay entitled "The Effect of Insurance Coverage on Preventive Care" (with Mark Cullen), explores the effect of insurance coverage on preventive care utilization. Using health insurance claims data from a large company, this paper examines the implementation of an insurance benefit design which differentially increased the marginal price of curative care (non-preventive care) while decreasing the marginal price of prevention. We examine the effect of the differential price change on the use of preventive procedures. We reveal evidence consistent with an important negative cross-price effect; that is, increases in the price of curative care can depress preventive care utilization.
Download or read book Essays on Contract written by P. S. Atiyah and published by Oxford University Press. This book was released on 1988 with total page 363 pages. Available in PDF, EPUB and Kindle. Book excerpt: P.S. Atiyah is one of the leading contract theorists of the common law world. These previously published essays, all revised or rewritten for this edition, constitute a comprehensive account of Atiyah's thoughts on the theory and foundation of contractual liability over the last twenty years, and include the author's replies to criticisms previously made of his work.
Download or read book Essays on the Economics of Selected Multi Period Insurance Decisions with Private Information written by Petra Steinorth and published by VVW GmbH. This book was released on 2011 with total page 146 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Petra Steinorth präsentiert in ihrer in englischer Sprache vorgelegten kumulativen Dissertationsschrift drei theoretische Modelle, die Versicherungsentscheidungen über mehrere Perioden und bei privater Information seitens der Versicherungsnehmer ökonomisch untersuchen. Die Dissertation leistet einen wichtigen Beitrag zur theoretischen Forschung im Bereich Versicherungsökonomie, da insbesondere zu mehrperiodigen Fragestellungen noch großer Forschungsbedarf besteht: Der Beitrag ""Impact of Health Savings Accounts on Precautionary Savings, Demand for Health Insurance and Prevention Effort"" untersucht den Einfluss von steuerlich begünstigten Gesundheitssparkonten auf das Sparverhalten, die Nachfrage nach Krankenversicherung und Prävention. Im zweiten Beitrag ""Yes, No, Perhaps - Explaining the Demand for Risk Classification Insurance with Imperfect Private Information"" wird untersucht, welche Granularität der Risikoklassifizierung optimal ist, wenn die Versicherungsnehmer unvollständige private Information über ihren zukünftigen Risikotyp haben. Der dritte Beitrag ""The Demand for Enhanced Annuities"" analysiert die Reaktion des Marktes auf die Einführung von sogenannten Enhanced Annuities. Dabei handelt es sich um Rentenversicherungsprodukte, die die individuelle Lebenserwartung bei der Tarifierung berücksichtigen. Die wissenschaftliche Arbeit ist auch für Mitarbeiter in Versicherungsunternehmen von Interesse, da sie wichtige Bereiche des Produktmanagements in der Lebens- und Krankenversicherung behandelt. Petra Steinorth ́s dissertation consists of three theoretical models, which all examine the economics of selected multi-period insurance decisions with private information on the part of the insured. The thesis makes an important contribution to insurance economics literature as multi-period problems have not yet been widely studied. The article ""Impact of Health Savings Accounts on Precautionary Savings, Demand for Health Insurance and Prevention Effort"" investigates how tax incentives like health savings accounts influence savings for medical costs, the demand for health insurance and ex ante moral hazard. The second article ""Yes, no, perhaps - Explaining the Demand for Risk Classification Insurance"" examines the optimal risk classification in case the insured have incomplete private information regarding their future risk type. The third article ""The Demand for Enhanced Annuities"" analyzes the market reaction to the introduction of so-called enhanced annuities, which are annuities that take individual factors influencing life expectancy into account for pricing. The scientific dissertation is also of interest to insurance practitioners as it examines important issues in the field of health and life insurance product management."
Download or read book Essays in Health Economics written by Juan Pablo Atal Chomali and published by . This book was released on 2016 with total page 149 pages. Available in PDF, EPUB and Kindle. Book excerpt: These essays study how private incentives affect the functioning of three dimensions of health care markets: health insurance, prescription drugs, and the delivery of health care by physicians. In the first chapter, I study the workings of long term health insurance, a form of contracts with the potential to efficiently insure individuals against reclassification risk, but at the expense of other limitations like provider lock-in. I empirically investigate the workings of long-term guaranteed-renewable contracts, which are subject to this tradeoff. Individuals are shielded against premium increases and coverage denial as long as they stay with their initial contract, but those that become higher risk are subject to premium increases or coverage denials upon switching, potentially leaving them locked-in with their original network of providers. I provide the first empirical evidence on the importance of this phenomenon using administrative panel data from the universe of the private health insurance market in Chile, where competing insurers offer guaranteed-renewable plans. I fit a structural model to yearly plan choices, and am able to jointly estimate evolving preferences for different insurance companies and supply-side underwriting in the form of premium risk-rating and coverage denial. To quantify the welfare effects of lock-in, I compare simulated choices under the current rules to those in a counterfactual scenario with no underwriting. The results show that consumers would be willing to pay around 13 percent more in yearly premiums to avoid lock-in. Finally, I study a counterfactual scenario where guaranteed-renewable contracts are replaced with community-rated spot contracts, and I find only minor general-equilibrium effects on premiums and on the allocation of individuals across insurers. I argue that these small effects are the result of large levels of preference heterogeneity uncorrelated to risk. In the second chapter, David Silver and I study worker interactions among the medical staff in the emergency department. Using rich administrative case-level data from two hospital-based emergency departments, we start by documenting peer effects among physicians. We find that physicians are 1.5 percent faster when working with peers who are 10 percent faster. We devise a test for random patient-physician assignment and we provide a number of tests to discern the mechanisms underlying these spillovers. The evidence points to spillovers that are driven primarily by faster peers responding negatively to working with slower peers. Utilization of shared resources accounts for little of the spillover, and event-study evidence points to spillovers that come into effect as soon as slower peers begin their shifts. In the third chapter, José Ignacio Cuesta, Morten Sæthre and I study regulations to pharmaceutical laboratories in the form of bioequivalence (BE) requirements -- the most prevalent tool used in developed economies to ensure the effectiveness of generic drugs allowed in the market. The main goal is to empirically investigate how the market reacts to BE requirements, and the consequences in prices, market shares, and product availability for branded and generic drugs. In particular, this study is an early exploration of the experience of Chile, where BE requirements were adopted for 172 molecules, leading to the BE approval of 642 generic drugs between March 2009 and March 2015. We show that the introduction of the requirements lead to a significant increase in BE approvals and in the share of BE drugs in the market. However, prices and market shares of other competing drugs were not significantly affected during the period we analyze. Other outcomes, like number of products, and market concentration are also found to be unaffected.
Download or read book An Essay on the Doctrine of Contracts written by Gulian Crommelin Verplanck and published by . This book was released on 1825 with total page 250 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Universal Health Insurance in France written by Victor Rodwin and published by . This book was released on 2006 with total page 234 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Insurance Risk Management and Public Policy written by Sandra G. Gustavson and published by Springer Science & Business Media. This book was released on 1993-10-31 with total page 199 pages. Available in PDF, EPUB and Kindle. Book excerpt: Five years ago the world lost one of its most prolific insurance scholars, Dr. Robert I. Mehr. His death in 1988 signalled the passing of not only a gifted writer and researcher, but also a pioneering teacher, mentor, and friend. The essays compiled within this volume are intended as an appropriate tribute to this occasionally outrageous individual who touched the lives of so many within the insurance community. Bob Mehr was a teacher who expected and demanded nothing less than perfect scholarship and flawless, efficient writing. Among alumni of the University of lllinois insurance doctoral program, stories still abound of late night and early morning sessions in which students and professor painstakingly debated precise words and phrases for dissertations, journal articles, and textbooks. Bob's respect for language was both immense and contagious, if at times more than a little compulsive. He joked that he could not read letters or novels without pencil in hand for editing. Bob's respect for his doctoral students was equally evident. The confidence he displayed in his students' abilities was sometimes startling, but "competence assumed" often begot "competence in fact." The accomplishments and records amassed by the many who studied with Bob Mehr are impressive and ongoing. On the dedication page in his final textbook, Fundamentals of Insurance, Bob spoke of his affection for those he called his "academic progeny" and wished them happiness as they build their own academic families.
