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Incomplete health insurance enrollment is a persistent U.S. challenge despite large subsidies. We ask whether hassles built into enrollment systems matter for insurance take-up and targeting. Studying removal of an auto-enrollment policy, we find that a small hassle - a requirement to actively...
Persistent link: https://www.econbiz.de/10013477273
With the goal of lowering incentives for alcohol and substance abuse, U.S. states have historically permitted private health insurers to deny reimbursement of medical claims stemming from alcohol or opioid impairment. However, a potential unintended consequence of such "exclusion provisions" is...
Persistent link: https://www.econbiz.de/10015421886
The pharmaceutical market has experienced a massive wave of vertical integration between pharmacy benefit managers (PBMs) and health insurers in recent years. Using a unique dataset on insurer-PBM contracts, we document increasing vertical integration in Medicare Part D-vertically integrated...
Persistent link: https://www.econbiz.de/10014337770
I demonstrate that to achieve dynamic efficiency, the optimal share of total surplus that a social payer should transfer to an innovating industry for a current asset depends on the marginal product of investment and the share of profits invested by the industry on the current asset and not on...
Persistent link: https://www.econbiz.de/10014544758
Governments in many low- and middle-income countries are developing health insurance products as a complement to tax-funded, subsidized provision of health care through publicly operated facilities. This paper discusses two rationales for this transition. First, health insurance would boost...
Persistent link: https://www.econbiz.de/10014247916
We investigate how formularies used by pharmacy benefit managers (PBMs) can affect manufacturer rebates for branded drugs. We first present a theoretical model of multidimensional contracting in which a PBM negotiates with drug manufacturers over menus of formulary-contingent rebate payments and...
Persistent link: https://www.econbiz.de/10015056114
We measure the impacts of vertical integration between insurers and hospitals. In the Chilean market, where half of private hospital capacity is vertically integrated, integration increases inpatient care spending by 6 percent and decreases consumer surplus and total welfare. Integrated insurers...
Persistent link: https://www.econbiz.de/10015056159
Recent policy proposals seek to regulate out-of-network hospital prices. We study how such regulation affects equilibrium prices, network formation, and hospital exit. We estimate a structural model of insurer-hospital bargaining that allows for out-of-network transactions between...
Persistent link: https://www.econbiz.de/10015398167
Opioid overdose deaths in older adults have increased substantially over the past two decades. This increase has occurred despite the availability of effective treatments. Methadone, one of just three medications approved by the Food & Drug Administration for opioid use disorder (OUD) treatment,...
Persistent link: https://www.econbiz.de/10014437015
Moral hazard and provider-induced demand may contribute to overutilization of scarce health care resources. The U.S. health care system includes several compensatory cost-containment mechanisms, but their effects depend on how patients and providers respond. We investigate hospice programs'...
Persistent link: https://www.econbiz.de/10014372448