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on Insurance Economics |
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Issue of 2019‒09‒09
nineteen papers chosen by Soumitra K. Mallick Indian Institute of Social Welfare and Business Management |
| By: | Borgschulte, Mark (University of Illinois at Urbana-Champaign); Vogler, Jacob (University of Illinois at Urbana-Champaign) |
| Abstract: | We estimate the effect of the Affordable Care Act Medicaid expansion on county-level mortality in the first four years following expansion. We find a reduction in all-cause mortality in ages 20 to 64 equaling 11.36 deaths per 100,000 individuals, a 3.6 percent decrease. This estimate is largely driven by reductions in causes of death likely to be influenced by access to health care, and equates to one life saved per 310 newly covered individuals. A cost-benefit analysis shows that the improvement in welfare due to mortality responses may offset the entire net-of-transfers expenditure associated with the expansion. |
| Keywords: | health insurance, Medicaid, mortality, public health insurance, healthcare, Affordable Care Act |
| JEL: | H75 I13 I14 I18 I38 |
| Date: | 2019–08 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp12552&r=all |
| By: | Lucie Schmidt; Lara Shore-Sheppard; Tara Watson |
| Abstract: | The Affordable Care Act (ACA) expanded the availability of public health insurance, decreasing the relative benefit of participating in disability programs but also lowering the cost of exiting the labor market to apply for disability program benefits. In this paper, we explore the impact of expanded access to Medicaid through the ACA on applications to the Supplemental Security Income (SSI) and Social Security Disability Income (SSDI) programs. Using the fact that the Supreme Court decision of June 2012 made the Medicaid expansion optional for the states, we compare changes in county-level SSI and SSDI caseloads in contiguous county pairs across a state border. We find no significant effects of the Medicaid expansion on applications or awards to either SSI or SSDI, and can reject economically meaningful impacts of Medicaid expansions on applications to disability programs. |
| JEL: | I10 I13 |
| Date: | 2019–08 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:26192&r=all |
| By: | Attar, Andrea; Mariotti, Thomas; Salanié, François |
| Abstract: | We study insurance markets in which privately informed consumers can purchase coverage from several firms whose pricing strategies are subject to an anti-dumping regulation. The resulting regulated game supports a single allocation in which each layer of coverage is fairly priced given the consumer types who purchase it. This competitive allocation cannot be Pareto-improved by a social planner who can neither observe consumer types nor monitor their trades with firms. Accordingly, we argue that public intervention under multiple contracting and adverse selection should penalize firms that cross-subsidize between contracts, while leaving consumers free to choose their preferred amount of coverage. |
| Keywords: | Insurance Markets, Regulation, Multiple Contracting, Adverse Selection. |
| JEL: | D43 D82 D86 |
| Date: | 2019–08 |
| URL: | http://d.repec.org/n?u=RePEc:tse:wpaper:123328&r=all |
| By: | French, Eric Baird; Jones, John Bailey; Kelly, Elaine; McCauley, Jeremy |
| Abstract: | In this review, we document end-of-life medical spending: its level, composition, funding and contribution to aggregate medical spending, both for the US and abroad. We discuss how end-of-life expenses affects household savings and other financial behaviour such as insurance choices. Lastly, we review economic evidence on the efficacy of medical spending at the end of life, assessing the value of palliative and other care for both longevity and patient satisfaction. |
| Keywords: | End of Life; Insurance; medical spending; Savings |
| JEL: | I12 I13 |
| Date: | 2019–08 |
| URL: | http://d.repec.org/n?u=RePEc:cpr:ceprdp:13913&r=all |
| By: | April Yanyuan Wu; Denise Hoffman; Paul O'Leary |
| Abstract: | The prevalence of opioid use nationwide, coupled with the large share of new Social Security Disability Insurance (SSDI) awardees who have conditions associated with opioid use, suggests that opioid use may be common and increasing among SSDI applicants. |
| Keywords: | Opioid use, SSDI applicants, disability |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:fc157553017a49f38a9c8058ae13007c&r=all |
| By: | Mörk, Eva (Uppsala University); Sjögren, Anna (IFAU); Svaleryd, Helena (Uppsala University) |
| Abstract: | We study the consequences of mothers' and fathers' job loss for parents, families, and children. Rich Swedish register data allow us to identify plant closures and account for non-random selection of workers to closing plants by using propensity score matching and controlling for pre-displacement outcomes. Our overall conclusion is positive: childhood health, educational and early adult outcomes are not adversely affected by parental job loss. Parents and families are however negatively affected in terms of parental health, labor market outcomes and separations. Limited effects on family disposable income suggest that generous unemployment insurance and a dual-earner norm shield families from financial distress, which together with universal health care and free education is likely to be protective for children. |
| Keywords: | parental unemployment, workplace closure, family environment, child health, human capital formation |
| JEL: | I12 J1 |
| Date: | 2019–08 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp12559&r=all |
| By: | Elyse Pegler; Nikki McKoy; Ethan Jacobs; Kate D'Anello |
| Abstract: | This case study describes how Atrius Health, a participant in the Pioneer Accountable Care Organization (ACO) model, has worked to improve behavioral health care for Medicare beneficiaries. |
| Keywords: | Pioneer ACO, Behavioral Health, Atrius Health, Case Study, Multi-Specialty Medical Practice, Evidence-Based Practices, Care Transformation |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:e14ce3c52c4f4d66a79555729b1c6cfe&r=all |
| By: | Rosch, Stephanie D.; Crane-Droesch, Andrew |
| Keywords: | Agricultural and Food Policy |
| Date: | 2019–06–25 |
| URL: | http://d.repec.org/n?u=RePEc:ags:aaea19:290914&r=all |
| By: | Boyer, Martin; De Donder, Philippe; Fluet, Claude; Leroux, Marie-Louise; Michaud, Pierre-Carl |
| Abstract: | We conduct a stated-choice experiment where respondents are asked to rate various insurance products aimed to protect against financial risks associated with long-term care needs. Using exogenous variation in prices from the survey design and individual cost estimates, these stated-choice probabilities are used to predict market equilibrium for long-term care insurance. We find that information frictions are pervasive. We measure the welfare losses associated with these three causes in a framework that also allows for selection. We show that information frictions reduce equilibrium take-up and lead to large welfare loss while selection plays little role. |
| Keywords: | Long-term care insurance; adverse selection; stated-preference; health; insurance |
| Date: | 2019–09–03 |
| URL: | http://d.repec.org/n?u=RePEc:tse:wpaper:123346&r=all |
| By: | Sharma, Sankalp; Walters, Cory G. |
| Keywords: | Agricultural and Food Policy |
| Date: | 2019–06–25 |
| URL: | http://d.repec.org/n?u=RePEc:ags:aaea19:290911&r=all |
| By: | Abhijit Banerjee; Amy Finkelstein; Rema Hanna; Benjamin A. Olken; Arianna Ornaghi; Sudarno Sumarto |
| Abstract: | To assess ways to achieve widespread health insurance coverage with financial solvency in developing countries, we designed a randomized experiment involving almost 6,000 households in Indonesia who are subject to a nationally mandated government health insurance program. We assessed several interventions that simple theory and prior evidence suggest could increase coverage and reduce adverse selection: substantial temporary price subsidies (which had to be activated within a limited time window and lasted for only a year), assisted registration, and information. Both temporary subsidies and assisted registration increased initial enrollment. Temporary subsidies attracted lower-cost enrollees, in part by eliminating the practice observed in the no subsidy group of strategically timing coverage for a few months during health emergencies. As a result, while subsidies were in effect, they increased coverage more than eightfold, at no higher unit cost; even after the subsidies ended, coverage remained twice as high, again at no higher unit cost. However, the most intensive (and effective) intervention – assisted registration and a full one-year subsidy – resulted in only a 30 percent initial enrollment rate, underscoring the challenges to achieving widespread coverage. |
| JEL: | I13 O15 |
| Date: | 2019–08 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:26204&r=all |
| By: | Dale-Olsen, Harald (Institute for Social Research, Oslo) |
| Abstract: | Does the creative destruction induced by unions entail increased social security uptake? Creative destruction implies the closures of less productive workplaces, and if the regional benefits from this process is not large enough, the displacements caused by workplace closures cause increased social security uptake. In this paper we apply a shift-share approach and historical unionisation data from 1918 to study the impact of regional unionisation changes in Norway on regional social security uptake during the period 2003-2012. As regional unionisation increases, inflows to regional unemployment and disability decrease, but the outflow to retirement increases. |
| Keywords: | trade unions, creative destruction, unemployment, disability insurance, retirement |
| JEL: | D24 J30 J51 |
| Date: | 2019–08 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp12546&r=all |
| By: | Ethan Jacobs; Denise Stone |
| Abstract: | This case study describes the strategy used by Boulder Valley Care Network (BVCN) to design a governance structure for its Accountable Care Organization (ACO) that promotes physician engagement. |
| Keywords: | Learning System for Accountable Care Organizations (LSACO), Accountable Care Organization (ACO), Boulder Valley Care Network (BVCN), Medicare Shared Savings Program (SSP), provider engagement, governance, case study |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:540f764d9bb54681a76e9c248103f445&r=all |
| By: | Xing, Yuying |
| Keywords: | Community/Rural/Urban Development |
| Date: | 2019–06–25 |
| URL: | http://d.repec.org/n?u=RePEc:ags:aaea19:291288&r=all |
| By: | Natalie Graves; Sonya Streeter |
| Abstract: | This case study describes UnityPoint Accountable Care’s approach to implementing a home visit program to improve the care experience and health outcomes of beneficiaries. |
| Keywords: | Next Generation ACO, home visit, home visit waiver, benefit enhancement |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:1de1136d9e5f4d69aaba9719dc0064d1&r=all |
| By: | Michael Anderson; Yonatan Ben-Shalom; David Stapleton; Emily Roessel |
| Abstract: | Awards of Social Security Disability Insurance (SSDI) benefits to disabled workers increased rapidly and then declined in the decade after the Great Recession began. |
| Keywords: | great recession, SSDI awards, Birth-cohort analysis, disability |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:b59814bdab3b477db7e5600d7c5ba7d7&r=all |
| By: | Rivka Weiser |
| Abstract: | This case study describes the care coordination initiative for rural providers developed by Rocky Mountain Accountable Care Organization (RMACO). |
| Keywords: | Learning System for Accountable Care Organizations (LSACO), Accountable Care Organization (ACO), Rocky Mountain Accountable Care Organization (RMACO), ACO Investment Model (AIM), rural health, care coordination, care management, case study |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:a94bb0c5b582471fa2cb01002b888922&r=all |
| By: | Natalie Graves |
| Abstract: | This case study describes the strategy that Bellin Health Partners Accountable Care Organization (Bellin ACO) developed to maximize the effectiveness of annual wellness visits (AWVs). |
| Keywords: | annual wellness visit, AWV, Next Generation ACO, NGACO |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:327f47ad518f4ac588b481009e141f55&r=all |
| By: | Ethan Jacobs |
| Abstract: | This case study describes the strategy used by Montefiore Accountable Care Organization (ACO) to engage physician practices in quality improvement activities. |
| Keywords: | Montefiore provider engagement, Next Generation Accountable Care Organization, NGACO, provider engagement, Montifiore ACO, quality measures |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:8a86859f452647489b87c8362df58474&r=all |