nep-ias New Economics Papers
on Insurance Economics
Issue of 2019‒04‒08
fifteen papers chosen by
Soumitra K. Mallick
Indian Institute of Social Welfare and Business Management

  1. Using Data to Drive State Improvement in Enrollment and Retention Performance By Christopher Trenholm; Mary Harrington; Andrew Snyder; Alice M. Weiss
  2. Health insurance and self-employment transitions in Vietnam By Le, Nga; Groot, Wim; Tomini, Sonila M.; Tomini, Florian
  3. Climate Risk and Beliefs: Evidence from New York Floodplains By Matthew Gibson; Jamie T. Mullins; Alison Hill
  4. Emerging Medicaid Accountable Care Organizations: The Role of Managed Care By Marsha Gold; Jessica Nysenbaum; Sonya Streeter
  5. The Value of Unemployment Insurance By Landais, Camille; Spinnewijn, Johannes
  6. Optimal Reinsurance and Investment in a Diffusion Model By Matteo Brachetta; Hanspeter Schmidli
  7. The Impact of Rapid Aging and Pension Reform on Savings and the Labor Supply By Hui He; Lei Ning; Dongming Zhu
  8. Durable Medical Equipment and Home Health Among the Largest Contributors to Area Variations in Use of Medicare Services (Journal Article) By James D. Reschovsky; Arkadipta Ghosh; Kate A. Stewart; Deborah J. Chollet
  9. Paying More for Primary Care: Can It Help Bend the Medicare Cost Curve? (Technical Appendix Brief) By James D. Reschovsky; Arkadipta Ghosh; Kate Stewart; Deborah Chollet
  10. Paying More for Primary Care: Can It Help Bend the Medicare Cost Curve? (Issue Brief) By James D. Reschovsky; Arkadipta Ghosh; Kate Stewart; Deborah Chollet
  11. The German Statutory Minimum Wage and Its Effects on Regional Employment and Unemployment By Bonin, Holger; Isphording, Ingo E.; Krause-Pilatus, Annabelle; Lichter, Andreas; Pestel, Nico; Rinne, Ulf
  12. Integrating Care for Dual Eligibles in New York: Issues and Options By James M. Verdier; Jenna Libersky; Jessica Gillooly
  13. Coordinating Care for Adults with Complex Care Needs in the Patient-Centered Medical Home: Challenges and Solutions By Eugene Rich; Debra Lipson; Jenna Libersky; Michael Parchman
  14. Life-Cycle Portfolios, Unemployment and Human Capital Loss By Fabio C. Bagliano; Carolina Fugazza; Giovanna Nicodano
  15. Policy Trade-Offs in Building Resilience to Natural Disasters: The Case of St. Lucia By Alessandro Cantelmo; Leo Bonato; Giovanni Melina; Gonzalo Salinas

  1. By: Christopher Trenholm; Mary Harrington; Andrew Snyder; Alice M. Weiss
    Abstract: The Maximizing Enrollment program has worked with eight states to help them use Medicaid and Children's Health Insurance Program enrollment and retention data to monitor and improve performance in enrolling and retaining eligible individuals.
    Keywords: Children's Health Insurance Program , Enrollment Retention , Performance , Medicaid
    JEL: I
  2. By: Le, Nga (UNU-MERIT); Groot, Wim (UNU-MERIT, TIER and CAPHRI School for Public Health and Primary Care, Maastricht University); Tomini, Sonila M. (UNU-MERIT); Tomini, Florian (Centre for Primary Care and Public Health Queen Mary University, London,)
    Abstract: Health insurance can have important effects on self-employment and self- employment transitions. However, there is a literature gap on the relationship between health insurance and self-employment in low and middle income countries, especially in the context of rapid expansion of health insurance in these countries. This paper examines this relationship in Vietnam with a focus on the comparison between the voluntary scheme for the informal sector (mostly self-employed workers) and the compulsory insurance for the formal sector (mostly wage workers). We employ a Probit model with selection on a panel from the Vietnamese Household Living Standards Surveys 2010-2014 to investigate the association between health insurance and self-employment entry and exit. We show that those with compulsory health insurance in Vietnam, the formal workers, are 10 percentage points less likely to enter self-employment compared to those having voluntary insurance. Regarding self-employment exit, people with compulsory insurance are more likely to exit self-employment compared to those covered by voluntary insurance. However, the effect size is relatively small.
    Keywords: health insurance, self-employment, Vietnam, self-employment entry, self-employment exit
    JEL: I13 J22
    Date: 2019–03–22
  3. By: Matthew Gibson (Williams College); Jamie T. Mullins (University of Massachusetts-Amherst); Alison Hill (Analysis Group)
    Abstract: Applying a difference-in-differences framework to a census of residential property transactions in New York City 2003-2017, we estimate the price effects of three flood risk signals: 1) the Biggert-Waters Flood Insurance Reform Act, which increased premiums; 2) Hurricane Sandy; and 3) new floodplain maps reflecting three decades of climate change. Estimates are negative for all three signals and some are large: properties included in the new floodplain after escaping flooding by Sandy experienced 18 percent price reductions. We investigate possible mechanisms, including selection of properties into the market and residential sorting. Finding no evidence for these, we develop a parsimonious theoretical model to study changes in flood beliefs. The model allows decomposition of our reduced-form estimates into the effects of insurance premium changes and belief updating. Results suggest that the new maps induced substantially larger belief changes than insurance reform.
    JEL: Q54 Q58 R30 G22
    Date: 2019–03
  4. By: Marsha Gold; Jessica Nysenbaum; Sonya Streeter
    Abstract: This brief, developed by staff at Mathematica and the Kaiser Family Foundation, looks at efforts by a number of states to set up accountable care organizations (ACOs) within their Medicaid programs.
    Keywords: ACOs , Accountable Care Organizations , Medicaid , Uninsured
    JEL: I
  5. By: Landais, Camille; Spinnewijn, Johannes
    Abstract: In the absence of unemployment insurance (UI) choices, the standard approach to estimating the value of UI is to infer it from the observed consumption response to job loss in combination with some assumption on preferences. Exploiting the unique data and policy context in Sweden, we propose two alternative approaches, which we implement and compare to the standard consumption-based approach on the exact same sample of workers. Our empirical analysis reveals that the drop in consumption expenditures upon job loss is relatively small (~ 13 percent), but that the marginal propensity to consume (MPC), estimated using variation in local government transfers, is 30 - 40 percent higher when unemployed than when employed. This wedge in MPCs, the focus of our first approach, reveals a high relative price of smoothing consumption, which confirms direct evidence on the limited consumption smoothing means available during unemployment. The estimated relative price provides a lower-bound on the value of UI, which turns out to be substantially higher than the consumption-based estimate under standard preference assumptions. Exploiting the UI choices embedded in the Swedish UI system, we also propose a Revealed-Preference approach, which confirms that the average value of UI is large in our setting, but also reveals substantial dispersion in the value of UI, above and beyond the variation in consumption drops.
    Keywords: Consumption Smoothing; MPC; Revealed Preference; Unemployment insurance
    JEL: H20 J64
    Date: 2019–03
  6. By: Matteo Brachetta; Hanspeter Schmidli
    Abstract: We consider a diffusion approximation to an insurance risk model where an external driver models a stochastic environment. The insurer can buy reinsurance. Moreover, investment in a financial market is possible. The financial market is also driven by the environmental process. Our goal is to maximise terminal expected utility. In particular, we consider the case of SAHARA utility functions. In the case of proportional and excess-of-loss reinsurance, we obtain explicit results.
    Date: 2019–03
  7. By: Hui He; Lei Ning; Dongming Zhu
    Abstract: We study, both empirically and quantitatively, the role of savings and the labor supply in self-insurance channels over the life cycle when one faces not only idiosyncratic income risks, but also changes in longevity risk and pension benefits. We pick China as a case study since China has undergone a dramatic process of rapid aging and a tremendous reduction in social security benefits for the period 1995-2009. We find that both savings and the labor supply are quantitatively important self-insurance channels in responding to changes in longevity risk and pension benefits, and the responses via adjustment to savings and labor supply have significant macroeconomic implications. Applying the model to China, we find that the pension reform and rapid aging together contribute 55 percent of the increase in the household saving rate from 1995 to 2009, and they jointly capture about 64 percent of the drastic increase in the labor supply for the same period.
    Date: 2019–03–18
  8. By: James D. Reschovsky; Arkadipta Ghosh; Kate A. Stewart; Deborah J. Chollet
    Abstract: This article investigates nationwide geographic variation in utilization of Medicare-covered services by service category.
    Keywords: Medical Equipment , Home Health , Medicare Services
    JEL: I
  9. By: James D. Reschovsky; Arkadipta Ghosh; Kate Stewart; Deborah Chollet
    Keywords: Primary Care , Medicare , Cost Curve , Health Reform
    JEL: I
  10. By: James D. Reschovsky; Arkadipta Ghosh; Kate Stewart; Deborah Chollet
    Abstract: This issue brief evaluates the effects of a permanent 10 percent increase in Medicare fees for primary care ambulatory visits on Medicare costs.
    Keywords: Primary Care , Medicare , Cost Curve , Health Reform
    JEL: I
  11. By: Bonin, Holger (IZA); Isphording, Ingo E. (IZA); Krause-Pilatus, Annabelle (IZA); Lichter, Andreas (Heinrich Heine University Düsseldorf); Pestel, Nico (IZA); Rinne, Ulf (IZA)
    Abstract: This paper studies the effects of the introduction of Germany's statutory minimum wage in 2015 on employment and unemployment on the level of regional labor markets. Using variation in the regional exposure to the new wage floor, we employ a difference-in-differences approach that compares the evolution of employment and unemployment between regions with varying minimum wage bites. Overall, we find no statistically significant effect of the introduction of the German minimum wage on regular employment subject to social insurance, but a statistically significant negative effect on marginal employment. The reduction is not accompanied by a proportional increase in unemployment.
    Keywords: minimum wage, employment, unemployment, labor market regions, Germany
    JEL: J21 J31 J38
    Date: 2019–03
  12. By: James M. Verdier; Jenna Libersky; Jessica Gillooly
    Abstract: This report for the New York State Health Foundation provides recommendations for New York State as it works to improve the coordination and integration of care dual eligibles receive through Medicare and Medicaid.
    Keywords: New York State Health , Dual Eligibles , Medicare , Medicaid
    JEL: I
  13. By: Eugene Rich; Debra Lipson; Jenna Libersky; Michael Parchman
    Abstract: Patients with complex health needs require both medical and social services and support from multiple providers and caregivers, and the patient-centered medical home (PCMH) offers a promising model for providing them comprehensive, coordinated care.
    Keywords: Patient-Centered Medical Home , Coordinating Care , Adult Care , Complex Needs
    JEL: I
  14. By: Fabio C. Bagliano (Department of Economics and Statistics (Dipartimento di Scienze Economico-Sociali e Matematico-Statistiche), University of Torino, Italy); Carolina Fugazza (Department of Economics and Statistics (Dipartimento di Scienze Economico-Sociali e Matematico-Statistiche), University of Torino, Italy); Giovanna Nicodano (Department of Economics and Statistics (Dipartimento di Scienze Economico-Sociali e Matematico-Statistiche), University of Torino, Italy)
    Abstract: The recent Great Recession highlighted that long-term unemployment spells may entail persistent losses in workers' human capital. This paper extends the life-cycle model of savings and portfolio choice with unemployment risk, by allowing the possibility of permanent reductions in expected earnings following long-term unemployment. The optimal risky portfolio share becomes flat in age due to the resolution of uncertainty about future returns to human capital that occurs as the worker ages. This may help explaining the observed relatively flat, or only moderately increasing, risky share of investors during working life, and have important consequences for the design of optimal life-cycle portfolios by investment funds.
    Keywords: life-cycle portfolio choice, unemployment risk, human capital depreciation, age rule.
    JEL: E21 G11
    Date: 2019–03
  15. By: Alessandro Cantelmo; Leo Bonato; Giovanni Melina; Gonzalo Salinas
    Abstract: Resilience to climate change and natural disasters hinges on two fundamental elements: financial protection —insurance and self-insurance— and structural protection —investment in adaptation. Using a dynamic general equilibrium model calibrated to the St. Lucia’s economy, this paper shows that both strategies considerably reduce the output loss from natural disasters and studies the conditions under which each of the two strategies provides the best protection. While structural protection normally delivers a larger payoff because of its direct dampening effect on the cost of disasters, financial protection is superior when liquidity constraints limit the ability of the government to rebuild public capital promptly. The estimated trade-off is very sensitive to the efficiency of public investment.
    Date: 2019–03–08

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