This paper develops and implements a statistical methodology to account for the equilibrium effects (aka adverse selection) in design of risk adjustment formula in health insurance markets. Our setting is modeled on the situation in Medicare and the new state Exchanges where individuals sort...

Quality reports or profiles of health care providers are inevitably based on only a measurable subset of the ``outputs" of the organization. Hospitals, for example, are being profiled on their mortality in the cardiac area but not in some other areas where mortality does not seem to be the...

In two important health policy contexts – private plans in Medicare and the new state-run “Exchanges” created as part of the Affordable Care Act (ACA) – plan payments come from two sources: risk-adjusted payments from a Regulator and premiums charged to individual enrollees. This paper...

New regulation of health insurance markets creates multiple levels of health plans, with designations like “Gold” and “Silver.” The underlying rationale for the heavy-metal approach to insurance regulation is that heterogeneity in demand for health care is not only due to health status...

This paper studies the role of Medicare's premium policy in sorting beneficiaries between traditional Medicare (TM) and managed care plans in the Medicare advantage (MA) program. Beneficiaries vary in their demand for care. TM fully accommodates demand but creates a moral hazard inefficiency. MA...

Changing health insurance coverage for one service may affect use of other insured services. When improving coverage for one service reduces use of another, the savings are referred to as “offset effects.” For example, costs of better coverage for prescription drugs may be partly...

The aim of The Elgar Companion to Health Economics is to take an audience of advanced undergraduates, postgraduates and researchers to the frontier of research in health economics, by providing them with short and easily readable introductions to key topics. The volume brings together 50...

This comprehensive collection brings together more than 50 contributions from some of the most influential researchers in health economics. It authoritatively covers theoretical and empirical issues in health economics, with a balanced range of material on equity and efficiency in health care...