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Market Structure and the Performance of the U.S. Health Insurance Marketplace

Market Structure and the Performance of the U.S. Health Insurance Marketplace PDF Author: Cassandra R. Cole
Publisher:
ISBN:
Category :
Languages : en
Pages : 0

Book Description
Health insurance premiums have more than doubled over the last ten years, with some suggesting that this may be the result of the high market concentration in the health insurance industry. In this paper, we conduct a state-level analysis in which we examine the health insurance marketplace, the degree of market concentration, and health insurance costs across states. We generally find that the barrier to entry into health insurance market is relatively low, as witnessed by the increase in the number of insurers operating in most states over the sample period; accordingly, the extent of market concentration has declined in recent years. We also find evidence of a positive relation between market concentration and insurer profits.

Market Structure and the Performance of the U.S. Health Insurance Marketplace

Market Structure and the Performance of the U.S. Health Insurance Marketplace PDF Author: Cassandra R. Cole
Publisher:
ISBN:
Category :
Languages : en
Pages : 0

Book Description
Health insurance premiums have more than doubled over the last ten years, with some suggesting that this may be the result of the high market concentration in the health insurance industry. In this paper, we conduct a state-level analysis in which we examine the health insurance marketplace, the degree of market concentration, and health insurance costs across states. We generally find that the barrier to entry into health insurance market is relatively low, as witnessed by the increase in the number of insurers operating in most states over the sample period; accordingly, the extent of market concentration has declined in recent years. We also find evidence of a positive relation between market concentration and insurer profits.

Market Structure of the Health Insurance Industry

Market Structure of the Health Insurance Industry PDF Author: D. Andrew Austin
Publisher: DIANE Publishing
ISBN: 1437926460
Category : Business & Economics
Languages : en
Pages : 65

Book Description


Health Insurance Market Structure and State-Based Public Option Laws

Health Insurance Market Structure and State-Based Public Option Laws PDF Author: Gerardo Ruiz Sanchez
Publisher:
ISBN:
Category :
Languages : en
Pages : 0

Book Description
In response to political gridlock at the federal level and concerns about market concentration in the private health insurance industry, several U.S. states have proposed their own bills to establish state-based public option programs, including three that recently became law in Washington State, Colorado, and Nevada. I study Washington State's Cascade Care Law, which implemented a state-based public option program in its individual health insurance market starting in 2021. I use plan offering data and administrative enrollment data from the Washington Health Benefit Exchange, Washington's state-based Affordable Care Act exchange, to provide a descriptive analysis of how market structure, insurers' plan offering decisions, individual enrollment, and market concentration evolved during the 2020-2022 plan years. A key descriptive finding of this paper is that county-level insurance market competition has improved since Washington's state-based public option program was implemented; with thirteen and twelve insurers offering plans in 2021 and 2022, respectively, up from nine insurers in 2020. I also document considerable variation in the set of plans insurers decided to offer and the set of counties they served. Enrollment in the public option plans that were offered was low.

Health-Care Utilization as a Proxy in Disability Determination

Health-Care Utilization as a Proxy in Disability Determination PDF Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
ISBN: 030946921X
Category : Medical
Languages : en
Pages : 161

Book Description
The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.

Three Essays on Market Structure, Competition, Prices, Health Spending, and Quality in the US Healthcare System

Three Essays on Market Structure, Competition, Prices, Health Spending, and Quality in the US Healthcare System PDF Author: James R Godwin
Publisher:
ISBN:
Category :
Languages : en
Pages : 192

Book Description
The United States spends a larger percentage of GDP on healthcare than any other OECD nation, and yet it performs poorly on measures of access, process quality and outcomes relative to other wealthy nations. One hypothesis that may explain the relatively poor performance of the United States' healthcare system per dollar spent is that markets for hospitals, physician services, and insurance are highly consolidated and lack competition. This dissertation contributes to the body of literature seeking to measure healthcare market structure and assess the relationship between this market structure and unit prices, overall spending, and healthcare quality. The first paper in this dissertation, "The Association between Hospital-Physician Vertical Integration and Outpatient Physician Prices Paid by Commercial Insurers: New Evidence," demonstrates market-level associations between vertical integration among hospitals and physicians and higher prices for outpatient care. The second essay, "How Hospital-Owned Physician Organizations are Associated with Healthcare Prices, Expenditures, and Quality," analyzes vertical integration and prices, quality, and total patient spending, building on the findings of the first essay using physician and hospital level claims data. This study finds that vertical integration is associated with higher levels of annual spending for patients attributed to vertically integrated providers, but interpretation of association between vertical integration and outpatient prices is confounded by pre-intervention trends. Analysis of CMS hospital outcome measures does not show associations between vertical integration at a hospital level and quality. Finally, the third essay, "Automated Delineation of Hospital Market Boundaries in California," explores geographic market definition in healthcare, an important topic in research and antitrust action, while assessing the application of community detection methods in this field. This study finds that community detection methods group hospitals with higher accuracy than other geographic markets as measured by patient flows and may offer promise for merger screening, research on market concentration, and research on geographic variation in healthcare. The final chapter reviews overarching limitations of the dissertation, outlines directions for future research, and comments on potential policy approaches to promote competition and address the symptoms that may result from highly consolidated healthcare markets

Health Insurance Industry Market Structure

Health Insurance Industry Market Structure PDF Author: Brent C. Jenner
Publisher: Nova Science Publishers
ISBN: 9781617612893
Category : Health insurance
Languages : en
Pages : 0

Book Description
This book discusses how the current health insurance market structure affects the two policy goals of expanding health insurance coverage and containing health care costs. Concerns about concentration in health insurance markets are linked to wider concerns about the cost, quality, and availability of health care. The market structure of the health insurance and hospital industries may have contributed to rising health care costs and deteriorating access to affordable health insurance and health care. Many features of the health insurance market and the ways it links to other parts of the health care system can hinder competition, lead to concentrated markets, and produce inefficient outcomes.

Moral Hazard in Health Insurance

Moral Hazard in Health Insurance PDF Author: Amy Finkelstein
Publisher: Columbia University Press
ISBN: 0231538685
Category : Medical
Languages : en
Pages : 161

Book Description
Addressing the challenge of covering heath care expenses—while minimizing economic risks. Moral hazard—the tendency to change behavior when the cost of that behavior will be borne by others—is a particularly tricky question when considering health care. Kenneth J. Arrow’s seminal 1963 paper on this topic (included in this volume) was one of the first to explore the implication of moral hazard for health care, and Amy Finkelstein—recognized as one of the world’s foremost experts on the topic—here examines this issue in the context of contemporary American health care policy. Drawing on research from both the original RAND Health Insurance Experiment and her own research, including a 2008 Health Insurance Experiment in Oregon, Finkelstein presents compelling evidence that health insurance does indeed affect medical spending and encourages policy solutions that acknowledge and account for this. The volume also features commentaries and insights from other renowned economists, including an introduction by Joseph P. Newhouse that provides context for the discussion, a commentary from Jonathan Gruber that considers provider-side moral hazard, and reflections from Joseph E. Stiglitz and Kenneth J. Arrow. “Reads like a fireside chat among a group of distinguished, articulate health economists.” —Choice

The Affordable Care Act

The Affordable Care Act PDF Author: Tamara Thompson
Publisher: Greenhaven Publishing LLC
ISBN: 0737771496
Category : Young Adult Nonfiction
Languages : en
Pages : 130

Book Description
The Patient Protection and Affordable Care Act (ACA) was designed to increase health insurance quality and affordability, lower the uninsured rate by expanding insurance coverage, and reduce the costs of healthcare overall. Along with sweeping change came sweeping criticisms and issues. This book explores the pros and cons of the Affordable Care Act, and explains who benefits from the ACA. Readers will learn how the economy is affected by the ACA, and the impact of the ACA rollout.

Performance of Financial Institutions

Performance of Financial Institutions PDF Author: Patrick T. Harker
Publisher: Cambridge University Press
ISBN: 9780521777674
Category : Business & Economics
Languages : en
Pages : 516

Book Description
The efficient operation of financial intermediaries--banks, insurance and pension fund firms, government agencies and so on--is instrumental for the efficient functioning of the financial system and the fueling of the economies of the twenty-first century. But what drives the performance of these institutions in today's global environment? In this volume, world-renowned scholars bring their expertise to bear on the issues. Primary among them are the definition and measurement of efficiency of a financial institution, benchmarks of efficiency, identification of the drivers of performance and measurement of their effects on efficiency, the impact of financial innovation and information technologies on performance, the effects of process design, human resource management policies, as well as others.

Coverage Matters

Coverage Matters PDF Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309076099
Category : Medical
Languages : en
Pages : 204

Book Description
Roughly 40 million Americans have no health insurance, private or public, and the number has grown steadily over the past 25 years. Who are these children, women, and men, and why do they lack coverage for essential health care services? How does the system of insurance coverage in the U.S. operate, and where does it fail? The first of six Institute of Medicine reports that will examine in detail the consequences of having a large uninsured population, Coverage Matters: Insurance and Health Care, explores the myths and realities of who is uninsured, identifies social, economic, and policy factors that contribute to the situation, and describes the likelihood faced by members of various population groups of being uninsured. It serves as a guide to a broad range of issues related to the lack of insurance coverage in America and provides background data of use to policy makers and health services researchers.