Abstract：
:The US health insurance industry is highly concentrated, and health insurance premiums are high and rising rapidly. Policymakers have focused on the possible link between the two, leading to ACA provisions to increase insurer competition. However, while market power may enable insurers to include higher profit margins in their premiums, it may also result in stronger bargaining leverage with hospitals to negotiate lower payment rates to partially offset these higher premiums. We empirically examine the relationship between employer-sponsored fully-insured health insurance premiums and the level of concentration in local insurer and hospital markets using the nationally-representative 2006-2011 KFF/HRET Employer Health Benefits Survey. We exploit a unique feature of employer-sponsored insurance, in which self-insured employers purchase only administrative services from managed care organizations, to disentangle these different effects on insurer concentration by constructing one concentration measure representing fully-insured plans' transactions with employers and the other concentration measure representing insurers' bargaining with hospitals. As expected, we find that premiums are indeed higher for plans sold in markets with higher levels of concentration relevant to insurer transactions with employers, lower for plans in markets with higher levels of insurer concentration relevant to insurer bargaining with hospitals, and higher for plans in markets with higher levels of hospital market concentration.
journal_name
J Health Econjournal_title
Journal of health economicsauthors
Trish EE,Herring BJdoi
10.1016/j.jhealeco.2015.03.009subject
Has Abstractpub_date
2015-07-01 00:00:00pages
104-14eissn
0167-6296issn
1879-1646pii
S0167-6296(15)00037-5journal_volume
42pub_type
杂志文章abstract：:Most health care evaluations today still assume expected utility even though the descriptive deficiencies of expected utility are well known. Prospect theory is the dominant descriptive alternative for expected utility. This paper tests whether prospect theory leads to better health evaluations than expected utility. ...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2009.09.002
更新日期：2009-12-01 00:00:00
abstract：:Most government employees have access to retiree health coverage, which provides them with group health coverage even if they retire before Medicare eligibility. We study the impact of retiree health coverage on the labor supply of public sector workers between the ages of 55 and 64. We find that retiree health covera...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2014.03.013
更新日期：2014-12-01 00:00:00
abstract：:We study an enhanced fee-for-service model for primary care physicians in the Family Health Groups (FHG) in Ontario, Canada. In contrast to the traditional fee-for-service (FFS) model, the FHG model includes targeted fee increases, extended hours, performance-based initiatives, and patient enrolment. Using a long pane...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2010.10.005
更新日期：2011-01-01 00:00:00
abstract：:One important motive for deregulating social health insurance is to encourage product innovation. For the first time, the cost savings achieved by non-US managed care plans that are attributable to product innovation are estimated, using a novel approach. Panel data from a major Swiss health insurer permits to infer h...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2003.12.007
更新日期：2004-09-01 00:00:00
abstract：:The price effects of the Swedish pharmaceutical substitution reform are analyzed using data for a panel of all pharmaceutical product sold in Sweden in 1997-2007. The price reduction due to the reform was estimated to average 10% and was found to be significantly larger for brand-name pharmaceuticals than for generics...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2010.08.003
更新日期：2010-12-01 00:00:00
abstract：:This paper analyzes how economic factors (relative expected earnings, relative expected hours worked, and relative length of training period) affect the distribution of medical residents across specialties. The results show that the percent of residents in a given specialty changes more than proportionately when relat...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/0167-6296(90)90050-d
更新日期：1990-11-01 00:00:00
abstract：:Evaluating Accountable Care Organizations is difficult because there is a great deal of heterogeneity in terms of their reimbursement incentives and other programmatic features. We examine how variation in reimbursement incentives and administration among two Medicaid managed care plans impacts utilization and spendin...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2014.03.001
更新日期：2014-07-01 00:00:00
abstract：:We experimentally evaluated the effects of in-kind team incentives on health worker performance in El Salvador, with 38 out of 75 community health teams randomly assigned to performance incentives over a 12-month period. All teams received monitoring, performance feedback and recognition for their achievements allowin...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2019.102267
更新日期：2020-03-01 00:00:00
abstract：:Despite the rapidly aging population, relatively little is known about how cost sharing affects the elderly's medical spending. Exploiting longitudinal claims data and the drastic reduction of coinsurance from 30% to 10% at age 70 in Japan, we find that the elderly's demand responses are heterogeneous in ways that hav...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2015.10.005
更新日期：2016-01-01 00:00:00
abstract：:We examine whether the availability of subsidized health insurance to the non-working population in Taiwan affected the labor force participation of married women. Our empirical identification exploits the fact that such insurance was first made available to wives of government employees, before being made universally...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/s0167-6296(00)00075-8
更新日期：2001-03-01 00:00:00
abstract：:In this paper we discuss the prioritisation of healthcare projects where there is a concern about health inequalities, but the decision maker is reluctant to make explicit quantitative value judgements and the data systems only allow the measurement of health at an aggregate level. Our analysis begins with a standard ...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2014.04.005
更新日期：2014-07-01 00:00:00
abstract：:Despite the growing literature on economic evaluation of health care programmes, little attention has been paid to the theoretical foundations of cost-effectiveness and cost utility analyses and the validity of the decision rules adopted as methods of achieving the stated goals. We show that although applications of t...
journal_title：Journal of health economics
pub_type： 杂志文章,评审
doi：10.1016/0167-6296(92)90004-k
更新日期：1992-10-01 00:00:00
abstract：:Understanding how physicians respond to incentives from payment schemes is a central concern in health economics research. We introduce a controlled laboratory experiment to analyse the influence of incentives from fee-for-service and capitation payments on physicians' supply of medical services. In our experiment, ph...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2011.05.001
更新日期：2011-07-01 00:00:00
abstract：:Comparative effectiveness research (CER) is thought to identify what works and does not work in health care. We interpret CER as infusing evidence on product quality into markets, shifting the relative demand for products in CER studies. We analyze how shifts in demand affect health and health care spending and demons...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2011.05.012
更新日期：2011-07-01 00:00:00
abstract：:We conducted a field experiment comparing hypothetical and real purchase decisions for a pharmacist provided asthma management program among 172 subjects with asthma. Subjects received either a dichotomous choice contingent valuation question or were given the opportunity to actually enroll in the program. Three diffe...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/s0167-6296(01)00075-3
更新日期：2001-05-01 00:00:00
abstract：:We performed an empirical elicitation of the equity-efficiency trade-off in cost-utility analysis using the rank-dependent quality-adjusted life-year (QALY) model, a model that includes as special cases many of the social welfare functions that have been proposed in the literature. Our elicitation method corrects for ...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2004.10.001
更新日期：2005-07-01 00:00:00
abstract：:This paper studies life-cycle preferences over consumption and health status. We show that cost-effectiveness analysis is consistent with cost-benefit analysis if the lifetime utility function is additive over time, multiplicative in the utility of consumption and the utility of health status, and if the utility of co...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/s0167-6296(99)00014-4
更新日期：1999-12-01 00:00:00
abstract：:Graduated driver licensing (GDL) is a critical policy tool for potentially improving teenage driving while reducing teen accident exposure. While previous studies demonstrated that GDL reduces teenage involvement in fatal crashes, much remains unanswered. We explore the mechanisms through which GDL influences accident...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2009.10.002
更新日期：2010-01-01 00:00:00
abstract：:This article analyses the redistributive effect caused by health financing and the distribution of healthcare utilization in Argentina before and during the severe 2001/2002 economic crisis. Both dramatically changed during this period: the redistributive effect became much more positive and utilization shifted from p...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2010.03.008
更新日期：2010-07-01 00:00:00
abstract：:The noncooperative character of resource allocation in a national health service may contribute to excessive waiting lists. A theory of hospital waiting lists is derived from this idea. Waiting lists imply loss of efficiency; the hospital's resources are drawn away from medical work. Although there is scope for Pareto...
journal_title：Journal of health economics
pub_type： 杂志文章,评审
doi：10.1016/0167-6296(93)90040-l
更新日期：1993-04-01 00:00:00
abstract：:We test whether the heightened mortality after the death of a spouse represents correlation or causation by examining the heterogeneity in the bereavement effect based on the spouse's cause of death. Some causes of death are correlated with socioeconomic characteristics while others are not. Equality in the bereavemen...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2008.04.001
更新日期：2008-09-01 00:00:00
abstract：:While recent research has shown that cannabis access laws can reduce the use of prescription opioids, the effect of these laws on opioid use is not well understood for all dimensions of use and for the general United States population. Analyzing a dataset of over 1.5 billion individual opioid prescriptions between 201...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2019.102273
更新日期：2020-01-01 00:00:00
abstract：:In a recent article in this journal Lee argued that indirect medical costs should be ignored in economic evaluations. To reach this conclusion, Lee uses an unrealistic and uncommon budget constraint. This comment highlights a number of methodological problems in Lee's analysis. Moreover, it highlights that looking at ...
journal_title：Journal of health economics
pub_type： 评论,杂志文章
doi：10.1016/j.jhealeco.2008.07.007
更新日期：2008-12-01 00:00:00
abstract：:This paper examines factors associated with differences in managed care penetration across geographic areas. Two alternative measures of managed care penetration are considered: the percentage of revenue physicians received from managed care contracts and market survey data on enrollments in managed care plans. Result...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/s0167-6296(97)00045-3
更新日期：1998-12-01 00:00:00
abstract：:In recent decades, China has experienced double-digit economic growth rates and rising inequality. This paper implements a new decomposition approach using the China Health and Nutrition Survey (1991-2006) to examine the extent to which changes in level and distribution of incomes and in income mobility are related to...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2013.10.002
更新日期：2013-12-01 00:00:00
abstract：:Although the effect of time to death (TTD) on health care expenditures (HCE) has been investigated using individual level data, the most profound implications of TTD have been for the forecasting of macro-level HCE. Here we estimate the TTD model using macro-level data from the Netherlands consisting of mortality rate...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2012.08.003
更新日期：2012-12-01 00:00:00
abstract：:EQ-5D is used in cost-effectiveness studies underlying many important health policy decisions. It comprises a survey instrument describing health states across five domains, and a system of utility values for each state. The original 3-level version of EQ-5D is being replaced with a more sensitive 5-level version but ...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2017.06.013
更新日期：2017-09-01 00:00:00
abstract：:This paper introduces the discrete choice model-paradigm of Random Regret Minimisation (RRM) to the field of health economics. The RRM is a regret-based model that explores a driver of choice different from the traditional utility-based Random Utility Maximisation (RUM). The RRM approach is based on the idea that, whe...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2012.10.007
更新日期：2013-01-01 00:00:00
abstract：:We present findings from a field experiment conducted at 40 elementary schools involving 8000 children and 400,000 child-day observations, which tested whether providing short-run incentives can create habit formation in children. Over a 3- or 5-week period, students received an incentive for eating a serving of fruit...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2015.11.004
更新日期：2016-01-01 00:00:00
abstract：:Tiered and narrow provider networks are mechanisms implemented by health plans to reduce health care costs. The benefits of narrow networks for consumers usually come in the form of lower premiums in exchange for access to fewer providers. Narrow networks may disrupt continuity of care and access to usual sources of c...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2018.06.006
更新日期：2018-07-01 00:00:00
