Background: We propose using neighborhood characteristics as demand-related morbidity adjusters to improve prediction models such as the risk equalization model. Results: Since the neighborhood has no explicit ‘place’ in healthcare demand models, we have developed the “Neighborhood and...

In theory, guaranteed renewable (GR) insurance contracts can efficiently protect individuals against reclassification risk without the negative side effects of price regulation, such as adverse selection. For these contracts to work properly, consumers must pay front-loaded premiums when healthy...

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...

Insurers subcontract with pharmacy benefit managers (PBMs) to administer drug insurance. PBMs typically profit from the difference between a fixed amount and the reimbursement paid to pharmacies (i.e., "spread pricing"). Some states require insurers and PBMs to use cost-plus contracts, in which...

This paper studies the propensities of the U.S. population to seek a full dose of vaccinations against the COVID-19 pandemic. Beyond the consideration of vaccine dissemination at the disaggregated or the local level, the main focus of this study is on determining whether a lack of health...

This paper studies the propensities of the U.S. population to seek a full dose of vaccinations against the COVID-19 pandemic. Beyond the consideration of vaccine dissemination at the disaggregated or the local level, the main focus of this study is on determining whether a lack of health...

Consumers rarely know the price of medical care before they consume it. I use variation in the timing of access to a new source of price information to show how access to and search for price information leads consumers to pay significantly less for care. I provide suggestive evidence that...

Risk classification refers to the use of observable characteristics by insurers to group individuals with similar expected claims, to compute the corresponding premiums, and thereby to reduce asymmetric information. Permitting risk classification may reduce informational asymmetry-induced...

Risk classification refers to the use of observable characteristics by insurers to group individuals with similar expected claims, compute the corresponding premiums, and thereby reduce asymmetric information. With perfect risk classification, premiums fully reflect the expected cost associated...

In many markets insurers are barred from price discrimination based on con- sumer characteristics like age, gender, and medical history. In this paper, I build on a recent literature to show why such policies are inefficient if consumers differ in their willingness-to-pay for insurance...