The existence of asymmetric information in insurance markets has been studied extensively in the economics literature, whereas the factors likely to influence asymmetric information have had less attention. Using individual level insurance data from a Takaful health insurance company located in...

In response to the significant premium increases and the “death spiral” concern, this research examines the stability and affordability of the ACA individual markets by quantifying appropriate premium increases in expanded cross-subsidization groups and determining cost reduction potentials....

Within the context of Medicare’s enunciated triple aims of better health, better care, and lower costs, we examine the effectiveness of medical loss ratio (MLR) on health outcomes of Medicare Advantage insurers. We simultaneously examine the effect of an efficiency measure for the insurer...

Taking an event-study approach, this paper examines the impact of the interest rate on the insurance industry and its sub-industries in contrast with other financials industries through the analysis of the stock market's reactions to federal funds rate changes. In addition to calculating the...

This research uses the input-oriented Data Envelopment Analysis (DEA) approach to examine the efficiency of the U.S. health insurers. It shows that more insurers are less efficient than the previous sample year; however, the results suggest that the federal health care reform have no significant...

This chapter presents an overview of the US health insurance market, reviews health insurance research literature, and examines premiums, medical expenses, medical service utilization, and data envelopment analysis (DEA) efficiency measures of health insurers from different perspectives. Results...

This research uses an indirect methodology to examine the effects of health insurance mergers and acquisitions by analyzing the impact of insurers' scale of operations and group affiliation status on benefits, costs, and efficiency from the perspective of various stakeholders. The analysis can...

The recent final rule on Medicaid managed care establishes the minimum medical loss ratio (MLR) requirement for Medicaid managed care and contains several provisions to strengthen delivery and payment reforms and improve efficiency and quality of care. Accordingly, this research examines the...

In response to the recent moves to reduce prescription drug expenses and eliminate manufacturer pharmaceutical rebates for Medicare and Medicaid, this research investigates the pass-through of manufacturer pharmaceutical rebates to premiums and examines the potential prescription drug cost...

Medicare faces significant financial challenges because of rising health care costs. In response, Medicare reform efforts have been testing various payment and service delivery models, including accountable care organizations (ACOs), aiming to reduce expenditures while preserving or enhancing...