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on Insurance Economics |
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Issue of 2019‒03‒11
nineteen papers chosen by Soumitra K. Mallick Indian Institute of Social Welfare and Business Management |
| By: | Timothy J. Halliday (University of Hawaii at Manoa UHERO, IZA); Tetine Sentell (University of Hawaii at Manoa); Megan Inada (Kokua Kalihi Valley Comprehensive Family Services); Randall Q. Akee (Brookings Institution and UCLA (on-leave) IZA, NBER); Victoria Y. Fan (University of Hawaii at Manoa Center for Global Development); Jill Miyamura (Hawaii Health Information Corporation) |
| Abstract: | In March of 2015, the State of Hawaii stopped covering migrants from countries belonging to the Compact of Free Association (COFA) in the state Medicaid program, forcing COFA migrants to obtain private insurance in health insurance exchanges established under the Affordable Care Act. Using statewide administrative hospital discharge data, we show that Medicaid-funded hospitalizations and emergency room visits declined in this population by 69% and 42% after the expiration of Medicaid eligibility. Utilization funded by private insurance did increase but not enough to offset the declines in publicly-funded utilization. This resulted in a net decrease in utilization. Paradoxically, we also find a substantial increase in Medicaid-funded ER visits by infants after the expiration of benefits which is consistent with a substitution of ER visits for ambulatory care for the very young. |
| Keywords: | Immigration, Health Insurance, Cost Sharing, Medicaid, Insurance Exchange |
| JEL: | I10 I14 J61 |
| Date: | 2019–02 |
| URL: | http://d.repec.org/n?u=RePEc:hai:wpaper:201904&r=all |
| By: | Choudhury, Mita (National Institute of Public Finance and Policy); Datta, Pritam (National Institute of Public Finance and Policy) |
| Abstract: | Private hospitals are expected to play a key role in the implementation of govern-ment sponsored health insurance schemes (GSHIS) in India. This paper examines the availability and spread of private hospitals in the country to provide insights on the po-tential access to insured health services in GSHIS schemes. It uses three sets of infor-mation to analyse the issue: private hospitals empanelled by insurance companies, the 6th Economic Census, and private hospitals empanelled in GSHIS schemes in four States. The analysis suggests that, in low-income States of the country, empanelment of private hos-pitals by insurance companies is low and concentrated in a few pockets. This pattern closely corresponds to the pattern of availability of private hospitals indicated in the 6th Economic Census. In Andhra Pradesh, Telangana, Tamil Nadu and Karnataka, the four States which have some of the largest GSHIS schemes in the country, there is a strong correspondence between private hospitals empanelled by insurance companies and pri-vate hospitals empanelled in GSHIS schemes. In these States, the extent of empanelment of private hospitals in GSHIS schemes is also substantially smaller than the empanelment of private hospitals by insurance companies. This may indicate differences in entry con-ditions or low willingness of private hospitals to participate in GSHIS schemes. |
| Keywords: | Private health providers ; Private hospitals, Ayushman Bharat ; Pradhan Man-tri Jan Arogya Yojana ; Access to health care ; India |
| JEL: | I11 I14 |
| Date: | 2019–02 |
| URL: | http://d.repec.org/n?u=RePEc:npf:wpaper:19/254&r=all |
| By: | Claire Wilson; Ann S. O’Malley; Carla Bozzolo; Nancy McCall; Sai Ma |
| Abstract: | As of 2015, the Centers for Medicare & Medicaid Services (CMS) pays for chronic care management (CCM) services for Medicare beneficiaries with two or more chronic conditions. |
| Keywords: | care management , chronic conditions , patient experiences , qualitative research , care coordination |
| JEL: | I |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:151b1d9b4e444a1eb91788f19855f2a9&r=all |
| By: | Andinet Woldemichael; Daniel Gurara; Abebe Shimeles |
| Abstract: | Achieving universal health coverage, including financial risk protection and access to quality essential health-care services, is one of the main Sustainable Development Goals. In low-income countries, innovative and affordable health financing systems are key to realize these goals. This paper assesses the impacts of Community-Based Health Insurance Scheme in Rwanda on health-related financial risks using a nationally representative household survey data collected over a ten-year period. We find that the scheme significantly reduce annual per capita out-of-pocket spending by about 3,600 Rwandan Franc (about US$12) or about 83 percent of average per capita healthcare expenditure compared to the baseline level in 2000.The impacts however favor the rich as compared to the poor. The program also reduces the incidence of catastrophic healthcare spending significantly. |
| Date: | 2019–02–22 |
| URL: | http://d.repec.org/n?u=RePEc:imf:imfwpa:19/38&r=all |
| By: | Andreeva, Andriyana; Yolova, Galina |
| Abstract: | The report examines some of the leading tendencies of anti-discriminatory policies in the sphere of health insurance. The problematic binds the aspects of discrimination in the examined area to the processes of digitalization in the contemporary society. On this basis after the performed analysis the authors make conclusions and recommendations. |
| Keywords: | health insurance; anti-discriminatory policies; digital society; digitalization |
| JEL: | K31 |
| Date: | 2018 |
| URL: | http://d.repec.org/n?u=RePEc:pra:mprapa:92499&r=all |
| By: | Priyanka Anand; Jody Schimmel Hyde; Maggie Colby; Paul O’Leary |
| Abstract: | In this paper, the authors estimate the impact of Medicaid expansions via the Patient Protection and Affordable Care Act (ACA) on applications to federal disability programs in 14 states that expanded Medicaid in January 2014. |
| Keywords: | Affordable Care Act, disability, medicaid |
| JEL: | I J |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:aeee3c037c004f378ad8f1108973a387&r=all |
| By: | Pierre Picard (CREST - Centre de Recherche en Economie et en Statistique - ENSAE ParisTech - École Nationale de la Statistique et de l'Administration Économique); Jennifer Wang; Kili Wang (TKU - Tamkang University [New Taipei]) |
| Abstract: | The outsourcing of retail services is frequently at the origin of agency costs, associated with the discretion in the way retailers do their job. This is particularly the case when retailers and customers collude to exploit loopholes in the contracts between producers and customers. In this paper, we analyze how insurance distribution channels may a¤ect such misbehaviors, when car repairers join policyholders to defraud insurers. We focus attention on the Taiwan automobile insurance market by using a database provided by two large Taiwanese automobile insurers. The theoretical underpinning of our analysis is provided by a model of claims fraud with collusion and audit. Our econometric analysis confirms that fraud occurs through the postponing of claims to the end of the policy year, possibly by filing a single claim for several events. It highlights the role of car dealer agencies in the collusive fraud mechanism.. |
| Date: | 2019–02–21 |
| URL: | http://d.repec.org/n?u=RePEc:hal:wpaper:hal-02045335&r=all |
| By: | Xavier Milhaud (SAF - Laboratoire de Sciences Actuarielle et Financière - UCBL - Université Claude Bernard Lyon 1 - Université de Lyon); Christophe Dutang (LMM - Laboratoire Manceau de Mathématiques - UM - Le Mans Université) |
| Abstract: | This paper deals with the crucial problem of modeling policyholders' behaviours in life insurance. We focus here on the surrender behaviours and model the contract lifetime through the use of survival regression models. Standard models fail at giving acceptable forecasts for the timing of surrenders because of too much heterogeneity, whereas the competing risk framework provides interesting insights and more accurate predictions. Numerical results follow from using Fine & Gray model ([13]) on an insurance portfolio embedding Whole Life contracts. Through backtests, this framework reveals to be quite efficient and recovers the empirical lapse rate trajectory by aggregating individual predicted lifetimes. These results could be particularly useful to design future insurance product. Moreover, this setting allows to calibrate experimental lapse tables, simplifying the lapse risk management for operational teams. |
| Date: | 2018–03–09 |
| URL: | http://d.repec.org/n?u=RePEc:hal:journl:hal-01985256&r=all |
| By: | Keaton S. Miller; Amil Petrin; Robert Town; Michael Chernew |
| Abstract: | When markets fail to provide socially optimal outcomes, governments often intervene through ‘managed competition’ where firms compete for per-consumer subsidies. Subsidies are generally set across geographies according to estimates of the cost of government provision, a method which may not be welfare-maximizing. We introduce a framework for determining the optimal subsidy schedule that features heterogeneity in consumer preferences and inertia, and firms with heterogeneous costs that can set prices and product characteristics in response to changes in the subsidy. We apply it to the Medicare Advantage program, which offers Medicare recipients private insurance that replaces Traditional Medicare. We calculate counterfactual equilibria as a function of the subsidies by estimating policy functions for product characteristics from the data and solving for Nash equilibria in prices. The optimal schedule increases consumer surplus by 30% over the current policy and is well-approximated with a linear rule using market-level observables. |
| JEL: | I11 L13 L51 |
| Date: | 2019–02 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:25616&r=all |
| By: | Andreeva, Andriyana; Yolova, Galina |
| Abstract: | Резюме В доклада се прави анализ на новите законодателни решения, свързани с еднодневните трудови договори при работници със сезонна заетост. Проблематиката се изследва в контекста на заетите в лозаро-винарството, като авторите анализират в комплексност трудовоправната и съответстващата й осигурителноправна уредба. На база на извършеният анализ и с оглед натрупана практика от момента на въвеждане на договора в КТ се правят изводи, обобщения и препоръки с практическа насоченост и с оглед усъвършенстване на нормите. Abstract The report analyzes the new legislative solutions, related to the individual day’s employment contracts for workers with seasonal employment. The problems are examined in the context of the workers in the wine-making, the authors analyze in complexity the labor law and the corresponding insurance law regulation. Based on the analysis and considering the practice from the moment of introducing this contract in the Labor code the authors make conclusions, summaries and recommendations with practical importance and with view of improvement of the norms. |
| Keywords: | employment contracts for short-term seasonal work; new employment contracts |
| JEL: | K31 |
| Date: | 2018 |
| URL: | http://d.repec.org/n?u=RePEc:pra:mprapa:92404&r=all |
| By: | International Monetary Fund |
| Abstract: | This Technical Note on Insurance Sector: Regulation and Supervision for Australia was prepared by a staff team of the International Monetary Fund as background documentation for the periodic consultation with the member country. It is based on the information available at the time it was completed on June 26, 2018. |
| Date: | 2019–02–21 |
| URL: | http://d.repec.org/n?u=RePEc:imf:imfscr:19/49&r=all |
| By: | Jin Sun; Ryle S. Perera; Pavel V. Shevchenko |
| Abstract: | We investigate an optimal investment-consumption and optimal level of insurance on durable consumption goods with a positive loading in a continuous-time economy. We assume that the economic agent invests in the financial market and in durable as well as perishable consumption goods to derive utilities from consumption over time in a jump-diffusion market. Assuming that the financial assets and durable consumption goods can be traded without transaction costs, we provide a semi-explicit solution for the optimal insurance coverage for durable goods and financial asset. With transaction costs for trading the durable good proportional to the total value of the durable good, we formulate the agent's optimization problem as a combined stochastic and impulse control problem, with an implicit intervention value function. We solve this problem numerically using stopping time iteration, and analyze the numerical results using illustrative examples. |
| Date: | 2019–03 |
| URL: | http://d.repec.org/n?u=RePEc:arx:papers:1903.00631&r=all |
| By: | Mdlulwa, Z.; Ngwane, C.; Mathebula, T. |
| Abstract: | Key government strategic development plans in South Africa have perpetually identified livestock farming as one of the vital strategies to alleviate poverty, secure livelihoods and improve food security in rural South Africa. However, livestock remains vulnerable to animal disease that threaten productivity and food security of smallholder farmers. Efficient animal production and control of animal diseases are identified as two of the main challenges that need urgent attention. Using data collected on 593 smallholder farmers in five provinces of South Africa, this paper uses partial proportional odds modelling to evaluate the determinants of livestock keeper's choice of primary animal health care practices. The primary animal health practises considered are biosecurity measures, vaccination and supplementary feeding. The analysis revealed that markets, animal handling facilities, contact with animal health practitioner, farmer association, household size, information, household income, number of goats and perceptions about the effectiveness and use of vaccines were the main determinants of farmer's choice of primary anima heath care practises. The study recommends intensification of programmes that seek to promote farmers; capacity development, social capital, improved inclusive facilitated access to markets and animal handling facilities in order to expedite increased farmers uptake of animal health care practises. Key words: Livestock, diseases, primary animal health care practices, partial proportional odds model, South Africa JEL codes: Q1, Q120 and D11 |
| Keywords: | Livestock Production/Industries |
| Date: | 2018–09–25 |
| URL: | http://d.repec.org/n?u=RePEc:ags:aeas18:284778&r=all |
| By: | Rachel Miller; Gina Livermore |
| Abstract: | This brief describes the characteristics of adults with mental health conditions who participate in the federal disability programs and reports evidence from three recent studies of longer-term impacts of supported employment (SE) on the employment of people with mental health conditions. |
| Keywords: | Social Security Disability Insurance, Supplemental Security Income, mental health, employment |
| JEL: | I J |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:96f98e817a2b4f13b36e5dd8a2d132cc&r=all |
| By: | Vesall Nourani (Massachusetts Institute of Technology); Christopher Barrett; Eleonora Patacchini (Cornell University); Thomas Walker (World Bank) |
| Abstract: | We model limited commitment informal insurance networks among individuals whose impurely altruistic marginal gains to giving to others diminish with the number of transfers one makes, giving is costly, and stochastic income has both publicly observable and unobservable components. Contrary to the canonical informal insurance model, in which bigger networks and observable income are preferable, our model predicts that unobservable income shocks may facilitate altruistic giving that better targets the least well of individuals within one's network and that too large a network can overwhelm even an altruistic agent, inducing her to cease giving. We test the empirical salience of the model using a unique data set from southern Ghana. We analyze transfer flows among households by coupling observations of gift-giving networks with experimental cash windfall gains - randomized between private and publicly observable payouts - repeated every other month for a year. The empirical evidence supports the model predictions. The magnitude and progressive targeting of transfers precipitated by private income gains underscores the importance of altruistic, and not just insurance, motives underpinning interhousehold transfers. Keywords: Informal insurance, networks, limited commitment, altruism, Ghana JEL classification: D140 O120 O170 |
| Date: | 2019–02–22 |
| URL: | http://d.repec.org/n?u=RePEc:adb:adbwps:2439&r=all |
| By: | Resul Cesur; Pinar Mine Gunes; Erdal Tekin; Aydogan Ulker |
| Abstract: | This paper examines the effect of a nationwide healthcare reform implemented in Turkey on women’s fertility decisions. The Family Medicine Program (FMP), introduced in 2005, provided a wide-range of primary healthcare services, free of charge, and achieved universal access by matching each citizen to a specific family physician, who operates at neighborhood clinics, called Family Health Centers, on a walk-in basis. Although reducing fertility was not specified among the goals of the reform, reproductive-health and family-planning services have been covered under the FMP. To establish causality, we exploit the staggered rollout of the FMP implementation across Turkish provinces over time using a difference-in-differences estimation strategy. Our estimates indicate that the FMP significantly reduced childbearing among both teenagers and women ages 20-29. These results can be explained by increased access to and reduced cost of reproductive-health and family-planning services. However, the patterns in which the program effect has evolved over time differs between the two groups of women in a way that provides additional insights about the mechanisms. For teenagers, the FMP had a direct effect on childbearing, reflected by an immediate and rapidly-increasing pattern, which is not surprising given the broad agreement about the negative consequences of teenage childbearing among government and public health officials, including those in Turkey. For women ages 20-29, however, the program had a gradual and slowly-increasing effect, which is consistent with an empowerment channel. This should be interpreted as an unintended consequence of the program because, if anything, Turkey is a country where the government’s position is to encourage fertility behavior and discourage birth control practices among women at prime childbearing ages. |
| JEL: | I10 I12 I13 I18 J13 |
| Date: | 2019–02 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:25605&r=all |
| By: | Andrea Albanese (Luxembourg Institute of Socio-Economic Research, Labour Market Department, Luxembourg; Department of Economics, Ghent University, Ghent, Belgium; IZA - Institute of Labor Economics, Bonn, Germany); Corinna Ghirelli (Bank of Spain); Matteo Picchio (Dipartimento di Scienze Economiche e Sociali - Universita' Politecnica delle Marche) |
| Abstract: | We study how unemployment benefit eligibility affects the layoff exit rate by exploiting quasiexperimental variation in eligibility rules in Italy. By using a difference-in-differences estimator, we find an instantaneous increase of about 12% in the layoff probability when unemployment benefit eligibility is attained, which persists for about 16 weeks. These findings are robust to different identifying assumptions and are mostly driven by jobs started after the onset of the Great Recession, in the South and for small firms. We argue that the moral hazard from the employer's side is the main force driving these layoffs. |
| Keywords: | Unemployment insurance, layoffs, employer-employee moral hazard, difference-in-differences, heterogeneous effects. |
| JEL: | C31 C41 J21 J63 J65 |
| Date: | 2019–02 |
| URL: | http://d.repec.org/n?u=RePEc:anc:wpaper:436&r=all |
| By: | Ludovic Gouden\`ege; Andrea Molent; Antonino Zanette |
| Abstract: | In this paper we develop an efficient approach based on a Machine Learning technique which allows one to quickly evaluate insurance products considering stochastic volatility and interest rate. Specifically, following De Spiegeleer et al., we apply Gaussian Process Regression to compute the price and the Greeks of a GMWB Variable Annuity. Starting from observed prices previously computed by means of a Hybrid Tree PDE approach for some known combinations of model parameters, it is possible to approximate the whole target function on a bounded domain. The regression algorithm consists of two main steps: algorithm training and evaluation. In particular, the first step is the most time demanding, but it needs to be performed only once, while the prediction step is very fast and requires to be performed only when evaluating the function. The developed method, as well as for the calculation of prices and Greeks, can also be employed to compute the no-arbitrage fee, which is a common practice in the Variable Annuities sector. We consider three increasing complexity models, namely the Black-Scholes, the Heston and the Heston Hull-White models, which extend the sources of randomness up to consider stochastic volatility and stochastic interest rate together. Numerical experiments show that the accuracy of the estimated values is high, while the computational cost is much lower than the one required by a direct calculation with standard approaches. Finally, we stress out that the analysis is carried out for a GMWB annuity but it could be generalized to other insurance products. Machine Learning seems to be a very promising and interesting tool for insurance risk management. |
| Date: | 2019–03 |
| URL: | http://d.repec.org/n?u=RePEc:arx:papers:1903.00369&r=all |
| By: | Boerma, Job; Karabarbounis, Loukas |
| Abstract: | We revisit the causes, welfare consequences, and policy implications of the dispersion in households' labor market outcomes using a model with uninsurable risk, incomplete asset markets, and home production. Accounting for home production amplifies welfare-based differences across households meaning that inequality is larger than we thought. Home production does not offset differences that originate in the market sector because productivity differences in the home sector are significant and the time input in home production does not covary with consumption expenditures and wages in the cross section of households. The optimal tax system should feature more progressivity taking into account home production. |
| Keywords: | Consumption; Home Production; inequality; Labor Supply |
| JEL: | D10 D60 E21 J22 |
| Date: | 2019–02 |
| URL: | http://d.repec.org/n?u=RePEc:cpr:ceprdp:13554&r=all |