We study how couples in the Medicare Part D program choose an insurance plan. Over 70 percent of enrollees choose the same plan as their spouse. Even among those with differing healthcare needs, well over half do so. Discrete-choice models suggest beneficiaries value being on the same plan as...

Public insurance reimbursement policies shape the structure and reach of healthcare markets. In this study, we examine the 1980 federal Medicaid mandate requiring states to reimburse Certified Nurse-Midwives, one of the first reforms targeting non-physician providers. We find the mandate...

In the 2000s, the Government of the People's Republic of China extended basic health insurance to most of the population. In the 2010s, it introduced a catastrophic medical insurance (CMI) program to further improve urban and rural residents' protection against financial shocks due to inpatient...

We study the spillover effects of a large-scale public health insurance programme on early learning outcomes in Rwanda. The policy, the community based health insurance programme, which expands affordable healthcare services especially among rural and low-income families, was introduced in...

Medicare fraud poses a substantial challenge to healthcare systems, resulting in significant financial losses and undermining the quality of care provided to legitimate beneficiaries. This study investigates the use of machine learning (ML) to enhance Medicare fraud detection, addressing key...

Social health protection systems are constantly evolving, offering a wide range of institutional, administrative, and financial arrangements. International standards in social health protection are outcome-based, and grant flexibility in the institutional and administrative arrangements chosen...

Die Sozialabgaben in Deutschland haben mit 42 % die einst als unüberschreitbar geltende "Haltelinie" von 40 % bereits deutlich überschritten. Besonders dramatisch entwickeln sich die Zusatzbeiträge der gesetzlichen Krankenversicherung (GKV): von 1,7 % im Jahr 2024 auf aktuell 2,9 % im zweiten...

We leverage decades of administrative data and quasi-experimental variation in the introduction of universal long-term care (LTC) insurance in Germany in 1995 to examine whether health insurance expansions can stimulate local economies. We find that the LTC insurance rollout led not only to...

A common approach to markets with adverse selection is to regulate competition to minimize inefficiencies, while preserving consumer choice among firms. We study the role of procurement auctions - leading to sole provision by the winning firm - as an alternative market design. Relative to...

Reaching universal health coverage is a central objective of social protection systems.Countries can choose a variety of mechanisms to secure the right to social health protection for all. This report focuses on those countries that have chosen a universal health insurance model. More...

The financing of long-term care services and supports (LTSS) relies heavily on self-insurance in the form of housing or financial wealth. Exploiting both local market variation in housing prices and individual-level variation in stock market wealth from 1996 to 2016, we document that exogenous...

In the Philippines, hospital efficiency and quality are rarely measured because of the limited availability of administrative health data. We used 37 million inpatient claims from PhilHealth (2018-2023) to estimate hospital efficiency and quality across the Philippines. We found stark variation...

Establishment of public-private partnerships is an emerging model in health care delivery. This study evaluates a pioneering social health insurance program in India that enables eligible households to access private hospitals for tertiary care services free of cost, but does not build more...

Establishment of public–private partnerships is an emerging model in health care delivery. This study evaluates a pioneering social health insurance program in India that enables eligible households to access private hospitals for tertiary care services free of cost, but does not build more...

This report estimated the utilization of outpatient benefits of the Philippine Health Insurance Corporation and examined variations across local governments. We analyzed utilization patterns by key socio-demographic and economic characteristics to better understand healthcare inequalities. The...

Inequities in access to healthcare are pervasive in many low- and middle-income countries (LMICs), manifesting as large socio-economic gradients in healthcare utilization and subsequently, disparities in population outcomes. LMICs additionally often confront inefficient health systems,...

The financing of long-term care services and supports (LTSS) relies heavily on self-insurance in the form of housing or financial wealth. Exploiting both local market variation in housing prices and individual-level variation in stock market wealth from 1996 to 2016, we document that exogenous...

Background Health is a crucial component of an economy, influencing the performance of various sectors. As a result, nearly every country has implemented health policies to achieve the United Nations Development Goals and Universal Health Coverage (UHC) targets, which focus on providing...

Objective To examine a 2018 rule change allowing pediatric providers to bill the child's Medicaid ID for post-partum depression (PPD) screening of mothers conducted during well-child visits, and document its relationship with PPD treatment and infant hospitalizations. Study setting and design...

Background Medicare Advantage (MA) penetration rates have shown an increase in rural areas in the past decade, increasing the bargaining power of MA plans relative to rural hospitals. We study the effect that this increase has had in the revenue of rural hospitals through reductions in the...

Background Adjusting the health insurance reimbursement rate is essential to optimize the allocation of medical resources. This paper investigates the effect of health insurance reimbursement rates on middle-aged and elderly people's choice of hospitals in China. Methods This study is conducted...

Background The COVID-19 pandemic has brought significant health shocks worldwide, along with a certain bur- den on healthcare systems. China's healthcare security system has been continuously improved and has essentially achieved universal coverage. Moreover, the health impact of COVID-19 on the...

Background Globally, health remains an important issue on governments agenda. Subsequently, the health insurance scheme was introduced in Ghana to reduce out-of-pocket payments for healthcare delivery. However, there are several challenges facing the scheme including continuous membership...

Universal health coverage is a widely shared goal across lower-income countries. We conducted a large-scale, 4-year trial that randomized premiums and subsidies for India’s first national, public hospital insurance program, called RSBY. We find substantial demand (∼ 60% uptake) even when...

Public insurance may disincentivize marriage, but for whom? Using the American Community Survey, we find that an increased likelihood of Medicaid eligibility owing to the Affordable Care Act reduces marriage rates, particularly among people with higher education levels. We develop a search model...

The examination of the causal impact of health insurance coverage on healthcare utilisation is a critical endeavour in both academic research and policy formulation. However, this endeavour faces challenges, notably the endogenous selection into coverage and prevalent misreporting of coverage...