nep-ias New Economics Papers
on Insurance Economics
Issue of 2019‒02‒18
28 papers chosen by
Soumitra K. Mallick
Indian Institute of Social Welfare and Business Management
  1. 'Til insurance do us part: the effect of the affordable care act preexisting conditions provision on marriage By J Matthew Hampton; Otto Lenhart
  2. Recent Patterns in Children's Medicaid Enrollment: A National View By Rosemary Borck; Valerie Cheh; Lucy Lu
  3. National health insurance scheme renewal in Ghana: Does waiting time at health insurance registration office matter? By Adu, Kofi Osei
  4. Treatment and Outcomes for Congestive Heart Failure by Race/Ethnicity in TRICARE By Ann D. Bagchi; Kate Stewart; Catherine McLaughlin; Patricia Higgins; Thomas Croghan
  5. Which States Have Limited Medicaid Managed Care Enrollment for Long-Term Care Users? By Valerie Cheh
  6. Why are employer-sponsored health insurance premiums higher in the public sector than in the private sector? By Alice M. Zawacki; Jessica P. Vistnes; Thomas C. Buchmueller
  7. Strategies to Compare Access to Care Among Medicaid Beneficiaries Versus other Populations By Joe Zickafoose; Allison Dodd; Deborah Chollet
  8. Stochastic Approximation Schemes for Economic Capital and Risk Margin Computations By David Barrera; Stéphane Crépey; Babacar Diallo; Gersende Fort; Emmanuel Gobet; Uladzislau Stazhynski
  9. Consumer Spending During Unemployment: Positive and Normative Implications By Peter Ganong; Pascal Noel
  10. Medicaid Access Monitoring Review Plans: Payment Rate Resource Toolkit By Deborah Chollet; Amanda Lechner
  11. Could There Be a Role for Home Telemedicine in the U.S. Medicare Program? By Lorenzo Moreno; Arnold Chen; Rachel Shapiro; Stacy Dale
  12. Quality and Resource Use Reports (QRURs): Frequently Asked Questions By Mathematica Policy Research
  13. Medicare Advantage 2011 Data Spotlight: Plan Availability and Premiums By Marsha Gold; Gretchen Jacobson; Anthony Damico; Tricia Neuman
  14. BOND Final Design Report By David Stapleton; Stephen Bell; David Wittenburg; Brian Sokol; Debi McInnis
  15. Survival pessimism and the demand for annuities By Cormac O'Dea; David Sturrock
  16. Methods to Identify Changes in Access Among Medicaid Beneficiaries By Risa Nakajima; Joe Zickafoose; Allison Dodd
  17. Lessons from the Field: Making Accountable Care Organizations Real By Timothy K. Lake; Kate A. Stewart; Paul B. Ginsburg
  18. Medicaid Access Resource Manual By Eric Morris; Risa Nakajima; Amanda Lechner; Christine O'Malley
  19. Who Will Enroll in Medicaid in 2014?: Lessons from Section 1115 Medicaid Waivers By Candace Natoli; Valerie Cheh; Shinu Verghese
  20. Medicaid Access Tool User Guide By Mathematica Policy Research
  21. Leveraging Benchmarks, Advisory Groups, and Experts to Understand Access in Medicaid By Amanda Lechner; Jenna Libersky; Joe Zickafoose; Allison Dodd; Deborah Chollet
  22. Mental Disorders Among Non-Elderly Nursing Home Residents By Samuel E. Simon; Debra J. Lipson; Christal M. Stone
  23. Monitoring Regional Access With Administrative Data By Deborah Chollet
  24. Participation in Healthy San Francisco: Trends in Enrollment and Retention By Margaret Colby; Catherine McLaughlin; Gregory Bee; Tricia Collins Higgins
  25. Does childcare improve the health of children with unemployed parents? Evidence from Swedish childcare access reform. By Aalto, Aino-Maija; Mörk, Eva; Sjögren, Anna; Svaleryd, Helena
  26. Effects of a Discharge Planning Program on Medicaid Coverage of State Prisoners with Serious Mental Illness By Audra T. Wenzlow; Henry T. Ireys; Bob Mann; Carol Irvin; Judith L. Teich
  27. A Short Note on Optimal Debt Management under Asymmetric Information By Faraglia, E.; Marcet, A.; Oikonomou, R.; Scott, A.
  28. The Patient-Centered Medical Homes: Strategies to Put Patients at the Center of Primary Care By Deborah Peikes; Janice Genevro; Sarah Scholle; Phyllis Torda
  1. By: J Matthew Hampton (department of Economics, University of Northern Iowa); Otto Lenhart (Department of Economics)
    Abstract: This paper investigates the effect of the 2014 Affordable Care Act pre-existing conditions provision on marriage. The policy was implemented to prevent insurers from denying insurance coverage to individuals with health conditions. We test whether the implementation of the provision led to decreases in marriage among affected adults. We add to earlier work on how marital behaviour is influenced by policy incentives and examine for the presence of "marriage lock", a situation in which individuals remain married primarily for insurance. Using data from 2009-2015 and difference-indifference models, we find that males with pre-existing conditions are 5.15 percentage points (6.4 percent) less likely to be married after the policy implementation. Effects are largest for men who had insurance coverage prior to the policy change from a source other than his own employer, suggesting that the inability to attain individual coverage and reliance on spousal insurance provided incentives to remain married.
    Keywords: Affordable care act, preexisting condititions, health insurance, marriage
    JEL: J12 I13 D1
    Date: 2019–02
    URL: http://d.repec.org/n?u=RePEc:str:wpaper:1902&r=all
  2. By: Rosemary Borck; Valerie Cheh; Lucy Lu
    Abstract: The MAX Medicaid policy issue brief series highlights the essential role MAX data can play in analyzing the Medicaid program. MAX is a set of annual, person-level data files on Medicaid eligibility, service utilization, and payments that are derived from state reporting of Medicaid eligibility and claims data into the Medicaid Statistical Information System (MSIS).
    Keywords: MAX , Medicaid , Children , Medicaid Enrollment , Health, Insurance Coverage
    JEL: I
    URL: http://d.repec.org/n?u=RePEc:mpr:mprres:7288013abfb3442cb9287a8cbeb3cca2&r=all
  3. By: Adu, Kofi Osei
    Abstract: The study examined effect of waiting time at national health insurance registration office on national health insurance renewal in Ghana and also, estimated acceptable waiting time at national health insurance registration office. A secondary data collected from 1009 individuals by PhD candidate at University of Cape Coast, Ghana was used for this study. The sample size used for this study was 636 and binary logit model was used to examine the effect of waiting time at national health insurance scheme office on renewal of national health insurance policy. The study found that waiting time at national health insurance scheme registration office/centre has a negative influence on individual’s decision to renew NHIS policy. The desired (acceptable) waiting time at NHIS registration centre is 2 hours 45 minutes (147 minutes). This means that individuals who spend less than 2 hours 45 minutes are more likely to renew their NHIS policy when the policy expires. This study recommends that National Health Insurance Authority should develop software (an App) that an individual can use to renew his/her NHIS membership when his/her membership expires without visiting NHIS registration office.
    Keywords: National health insurance scheme, waiting time and health insurance renewal
    JEL: I1 I13 I15
    Date: 2019–01–01
    URL: http://d.repec.org/n?u=RePEc:pra:mprapa:91961&r=all
  4. By: Ann D. Bagchi; Kate Stewart; Catherine McLaughlin; Patricia Higgins; Thomas Croghan
    Abstract: This study examines racial/ethnic disparities in the treatment and outcomes of care for TRICARE beneficiaries with congestive heart failure.
    Keywords: Congestive Heart Failure, Race/Ethnicity , TRICARE , Health Insurance Coverage
    JEL: I
    URL: http://d.repec.org/n?u=RePEc:mpr:mprres:bb3b5fb6330449f7a12fcfa0c4a94106&r=all
  5. By: Valerie Cheh
    Abstract: The MAX Medicaid policy issue brief series highlights the essential role MAX data can play in analyzing the Medicaid program.
    Keywords: MAX , Medicaid , Medicaid Managed Care , Long-Term Care , Health
    JEL: I
    URL: http://d.repec.org/n?u=RePEc:mpr:mprres:f616f6bc9db9432badc732a84fe9b207&r=all
  6. By: Alice M. Zawacki; Jessica P. Vistnes; Thomas C. Buchmueller
    Abstract: In this article, we examine the factors explaining differences in public and private sector health insurance premiums for enrollees with single coverage. We use data from the 2000 and 2014 Medical Expenditure Panel Survey-Insurance Component, along with decomposition methods, to explore the relative explanatory importance of plan features and benefit generosity, such as deductibles and other forms of cost sharing, basic employee characteristics (e.g., age, gender, and education), and unionization. While there was little difference in public and private sector premiums in 2000, by 2014, public premiums had exceeded private premiums by 14 to 19 percent. We find that differences in plan characteristics played a substantial role in explaining premium differences in 2014, but they were not the only, or even the most important, factor. Differences in worker age, gender, marital status, and educational attainment were also important factors, as was workforce unionization.
    Date: 2019–02
    URL: http://d.repec.org/n?u=RePEc:cen:wpaper:19-03&r=all
  7. By: Joe Zickafoose; Allison Dodd; Deborah Chollet
    Abstract: This brief presents statistical methods that staff in state Medicaid agencies could use to assess how well their Medicaid program is meeting the goal of access to care for Medicaid beneficiaries that is comparable to that for populations with other sources of coverage.
    Keywords: AMRP, access, Medicaid, fee-for-service, measures, methods
    JEL: I
    URL: http://d.repec.org/n?u=RePEc:mpr:mprres:bbacfec9017c4627b36a7f456d7c6f4e&r=all
  8. By: David Barrera (CMAP - Centre de Mathématiques Appliquées - Ecole Polytechnique - X - École polytechnique - CNRS - Centre National de la Recherche Scientifique); Stéphane Crépey (LaMME - Laboratoire de Mathématiques et Modélisation d'Evry - INRA - Institut National de la Recherche Agronomique - UEVE - Université d'Évry-Val-d'Essonne - ENSIIE - CNRS - Centre National de la Recherche Scientifique); Babacar Diallo (LaMME - Laboratoire de Mathématiques et Modélisation d'Evry - INRA - Institut National de la Recherche Agronomique - UEVE - Université d'Évry-Val-d'Essonne - ENSIIE - CNRS - Centre National de la Recherche Scientifique); Gersende Fort (IMT - Institut de Mathématiques de Toulouse UMR5219 - UT1 - Université Toulouse 1 Capitole - UT2J - Université Toulouse - Jean Jaurès - UPS - Université Toulouse III - Paul Sabatier - Université Fédérale Toulouse Midi-Pyrénées - PRES Université de Toulouse - INSA Toulouse - Institut National des Sciences Appliquées - Toulouse - INSA - Institut National des Sciences Appliquées - CNRS - Centre National de la Recherche Scientifique); Emmanuel Gobet (CMAP - Centre de Mathématiques Appliquées - Ecole Polytechnique - X - École polytechnique - CNRS - Centre National de la Recherche Scientifique); Uladzislau Stazhynski (CMAP - Centre de Mathématiques Appliquées - Ecole Polytechnique - X - École polytechnique - CNRS - Centre National de la Recherche Scientifique)
    Abstract: We consider the problem of the numerical computation of its economic capital by an insurance or a bank, in the form of a value-at-risk or expected shortfall of its loss over a given time horizon. This loss includes the appreciation of the mark-to-model of the liabilities of the firm, which we account for by nested Monte Carlo à la Gordy and Juneja (2010) or by regression à la Broadie, Du, and Moallemi (2015). Using a stochastic approximation point of view on value-at-risk and expected shortfall, we establish the convergence of the resulting economic capital simulation schemes, under mild assumptions that only bear on the theoretical limiting problem at hand, as opposed to assumptions on the approximating problems in Gordy-Juneja (2010) and Broadie-Du-Moallemi (2015). Our economic capital estimates can then be made conditional in a Markov framework and integrated in an outer Monte Carlo simulation to yield the risk margin of the firm, corresponding to a market value margin (MVM) in insurance or to a capital valuation adjustment (KVA) in banking par- lance. This is illustrated numerically by a KVA case study implemented on GPUs.
    Date: 2019
    URL: http://d.repec.org/n?u=RePEc:hal:journl:hal-01710394&r=all
  9. By: Peter Ganong (Chicago Harris School of Public Policy); Pascal Noel (University of Chicago Booth School of Business)
    Abstract: Using de-identified bank account data, we show that spending drops sharply at the large and predictable decrease in income arising from the exhaustion of unemployment insurance (UI) benefits. We use the high-frequency response to a predictable income decline as a new test to distinguish between alternative consumption models. The sensitivity of spending to income we document is inconsistent with rational models of liquidity-constrained households, but is consistent with behavioral models with present-biased or myopic households. Depressed spending after exhaustion also implies that the consumption-smoothing gains from extending UI benefits are four times larger than from raising UI benefit levels.
    Keywords: unemployment, spending, buffer stock, Baily-Chetty
    JEL: E21 E24 J65
    Date: 2019–02
    URL: http://d.repec.org/n?u=RePEc:hka:wpaper:2019-006&r=all
  10. By: Deborah Chollet; Amanda Lechner
    Abstract: The Payment Resource Toolkit is a resource to help states identify and access data on Medicaid, Medicare, and commercial payment rates.
    Keywords: AMRP, access, Medicaid, fee-for-service, measures, methods
    JEL: I
    URL: http://d.repec.org/n?u=RePEc:mpr:mprres:573c8a4a03e242aab421efc176489abf&r=all
  11. By: Lorenzo Moreno; Arnold Chen; Rachel Shapiro; Stacy Dale
    Abstract: This book chapter looks at the CMS-funded Informatics for Diabetes Education and Telemedicine demonstration.
    Keywords: Home Telemedicine , Medicare Program , Health Care Costs , Diabetes
    JEL: I
    URL: http://d.repec.org/n?u=RePEc:mpr:mprres:431abfcb28124b6d81460c3a8db7e08d&r=all
  12. By: Mathematica Policy Research
    Abstract: These FAQs offer information on 2010 Quality and Resource Use Reports, Phase II of the Physician Feedback Program established under Medicare and expanded by the Affordable Care Act.
    Keywords: QRUR , Quality and Resource Use Reports , Medicare , Health
    JEL: I
    URL: http://d.repec.org/n?u=RePEc:mpr:mprres:42c5d6d01c5548edbcec29e3ff36bdc3&r=all
  13. By: Marsha Gold; Gretchen Jacobson; Anthony Damico; Tricia Neuman
    Abstract: This new data spotlight reviews changes to Medicare Advantage plans and examines trends in plan participation, premiums, and certain benefits. Overall, enrollees can expect modest changes in 2011. On average, beneficiaries will be able to choose from among 24 plans.
    Keywords: Medicare Advantage Plan Availability Medicare Beneficiaries Enrollees
    JEL: I
    URL: http://d.repec.org/n?u=RePEc:mpr:mprres:a36d85a20fd240c1b4b4da4042423878&r=all
  14. By: David Stapleton; Stephen Bell; David Wittenburg; Brian Sokol; Debi McInnis
    Abstract: BOND will test innovations to address the financial disincentives and other obstacles to increasing incomes and reducing dependence on Social Security Disability Insurance (SSDI) benefits.
    Keywords: BOND , Benefit Offset National Demonstration , SSA , Disability
    JEL: I J
    URL: http://d.repec.org/n?u=RePEc:mpr:mprres:206a9aecdee7425f97f86d3583394661&r=all
  15. By: Cormac O'Dea (Institute for Fiscal Studies); David Sturrock (Institute for Fiscal Studies and Institute for Fiscal Studies)
    Abstract: The "annuity puzzle" refers to the fact that annuities are rarely purchased despite the longevity insurance they provide. Most explanations for this puzzle assume that individuals have accurate expectations about their future survival. We provide evidence that individuals mis-perceive their mortality risk, and study the demand for annuities in a setting where annuities are priced by insurers on the basis of objectively-measured survival probabilities but in which individuals make purchasing decisions based on their own subjective survival probabilities. Subjective expectations have the capacity to explain signi cant rates of non-annuitization, yielding a quantitatively important explanation for the annuities puzzle.
    Keywords: Annuity Puzzle, Subjective Expectations, Survival Probabilities
    Date: 2019–01–17
    URL: http://d.repec.org/n?u=RePEc:ifs:ifsewp:19/02&r=all
  16. By: Risa Nakajima; Joe Zickafoose; Allison Dodd
    Abstract: This brief presents methods that state Medicaid agencies can use to assess changes in access as part of their AMRPs.
    Keywords: AMRP, access, Medicaid, fee-for-service, measures, methods
    JEL: I
    URL: http://d.repec.org/n?u=RePEc:mpr:mprres:7ce99118507642258e7ff8165e445c5c&r=all
  17. By: Timothy K. Lake; Kate A. Stewart; Paul B. Ginsburg
    Abstract: This study examined providers' efforts to improve care delivery, similar to those likely to be encouraged under ACOs.
    Keywords: ACOs , Accountable Care Organizations , Health Care Reform , Health Care Quality
    JEL: I
    URL: http://d.repec.org/n?u=RePEc:mpr:mprres:331d40b1d842436d89888f5435e3b223&r=all
  18. By: Eric Morris; Risa Nakajima; Amanda Lechner; Christine O'Malley
    Abstract: This Resource Manual includes 32 measures that states can choose to report in their Access Monitoring Review Plans (AMRPs).
    Keywords: AMRP, access, Medicaid, fee-for-service, measures, methods
    JEL: I
    URL: http://d.repec.org/n?u=RePEc:mpr:mprres:68f1db12dd6f4556a98d2a455fa2153b&r=all
  19. By: Candace Natoli; Valerie Cheh; Shinu Verghese
    Abstract: The MAX Medicaid policy issue brief series highlights the essential role MAX data can play in analyzing the Medicaid program.
    Keywords: Medicaid , MAX , Section 1115 Medicaid Waivers
    JEL: I
    URL: http://d.repec.org/n?u=RePEc:mpr:mprres:4a6dd9b4b3fb427e9edef9212e19cf92&r=all
  20. By: Mathematica Policy Research
    Abstract: This document provides instructions on how to use the Medicaid Access Data Collection tool as well as a description of the processing that occurs within it.
    Keywords: AMRP, access, Medicaid, fee-for-service, measures, methods
    JEL: I
    URL: http://d.repec.org/n?u=RePEc:mpr:mprres:fadc7fd908024a8fb4d1f66672b7dea5&r=all
  21. By: Amanda Lechner; Jenna Libersky; Joe Zickafoose; Allison Dodd; Deborah Chollet
    Abstract: This brief presents a process that staff in state Medicaid agencies can use to engage resources – such as benchmarks, subject matter experts, and advisory groups—in the development of their access monitoring review plans.
    Keywords: AMRP, access, Medicaid, fee-for-service, measures, methods
    JEL: I
    URL: http://d.repec.org/n?u=RePEc:mpr:mprres:7396d1519d294e0a87f97fe0fa9fd064&r=all
  22. By: Samuel E. Simon; Debra J. Lipson; Christal M. Stone
    Abstract: Despite federal nursing home policies designed to prevent inappropriate institutionalization, many Medicaid beneficiaries under age 65 with serious mental illness may be inappropriately admitted to nursing facilities.
    Keywords: Mental Disorders , Nursing Home Residents , antipsychotic, claims data, IMD Medicaid, Mental Illness, Olmstead
    JEL: I J
    URL: http://d.repec.org/n?u=RePEc:mpr:mprres:17be28f28b9442cd972e776b2c51e684&r=all
  23. By: Deborah Chollet
    Abstract: This brief presents two methods that state Medicaid agencies can use to assess regional differences in access.
    Keywords: AMRP, access, Medicaid, fee-for-service, measures, methods
    JEL: I
    URL: http://d.repec.org/n?u=RePEc:mpr:mprres:be420343846b4eba86412b3f75707922&r=all
  24. By: Margaret Colby; Catherine McLaughlin; Gregory Bee; Tricia Collins Higgins
    Abstract: This report examines enrollment and retention in Healthy San Francisco, a health care access program for uninsured adults in the city and county of San Francisco.
    Keywords: Healthy San Francisco , Enrollment , Retention
    JEL: I
    URL: http://d.repec.org/n?u=RePEc:mpr:mprres:b8b82a8998114492986f8720c7834c39&r=all
  25. By: Aalto, Aino-Maija (UCLS, Uppsala Universitet); Mörk, Eva (Uppsala universitet); Sjögren, Anna (IFAU - Institute for Evaluation of Labour Market and Education Policy); Svaleryd, Helena (Uppsala universitet)
    Abstract: We analyze how access to childcare affects the health outcomes of children with unemployed parents using a reform that increased childcare access in some Swedish municipalities. While we find no effects of childcare access on hospitalization for 2- to 3-year-olds, our results suggest that 4- to 5-year-olds were more likely to be hospitalized due to infections when they first gained access to childcare. Children aged 10 to 11 years who had access to childcare earlier in their childhood, while their parents were unemployed, were less likely to be prescribed medication for respiratory conditions and allergies. Taken together, our results suggest that the immediate health consequences of childcare access for children of unemployed parents are limited. Our findings support previous evidence that the greater exposure to microorganisms induced by childcare attendance may reduce the risk of developing allergies and asthma.
    Keywords: Childcare; Child health; Unemployment; Quasi-experiment
    JEL: I14 J13
    Date: 2019–02–08
    URL: http://d.repec.org/n?u=RePEc:hhs:ifauwp:2019_001&r=all
  26. By: Audra T. Wenzlow; Henry T. Ireys; Bob Mann; Carol Irvin; Judith L. Teich
    Abstract: This study assessed the effectiveness of a discharge planning program implemented in three Oklahoma state prisons to assist inmates with serious mental illness to enroll in Medicaid on the day of release or soon thereafter.
    Keywords: Mental Illness , Prisoners , Medicaid Coverage , Oklahoma
    JEL: I J
    URL: http://d.repec.org/n?u=RePEc:mpr:mprres:b335f122fa3c4326896d657d822353d8&r=all
  27. By: Faraglia, E.; Marcet, A.; Oikonomou, R.; Scott, A.
    Abstract: We show that under asymetric information, if the government holds advanced information relative to the investors.some debt management policies may lead to bond market instability. The In particular, we show that the repurchase/reissuance strategy assumd in most of the current debt management literature would cause such a crisis and it would be therefore highly suboptimal.of a bond below its maturity this does compromise the ability of long bonds to provide fiscal insurance.
    Date: 2019–02–11
    URL: http://d.repec.org/n?u=RePEc:cam:camdae:1761&r=all
  28. By: Deborah Peikes; Janice Genevro; Sarah Scholle; Phyllis Torda
    Abstract: This brief offers strategies for decision makers for the patient-centered medical home to respond to and reflect the goals, preferences, and needs of patients and their families.
    Keywords: Patient-Centered Medical Home, PCMH , Primary Care, Health
    JEL: I
    URL: http://d.repec.org/n?u=RePEc:mpr:mprres:5f25294246e34e2b8d3aa5fec35c02b2&r=all
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