Cost-effectiveness analysis often plays an important role in prioritization among different types of public health expenditures. Cost-effectiveness is defined as the maximal health benefits for given expenditures on health care. With a private health sector as a supplement to the public sector,...

Over the last decade, the U.S. Medicare program has added new billing codes to enhance the financial rewards for Chronic Care Management and Transitional Care Management. We show that the take-up of these new billing codes is gradual and exhibits substantial variations across markets and...

Over the last decade, the U.S. Medicare program has added new billing codes to enhance the financial rewards for Chronic Care Management and Transitional Care Management. We show that the take-up of these new billing codes is gradual and exhibits substantial variations across markets and...

Many competitive health insurance markets adjust payments to participating health plans according to their enrollees' risk - including based on diagnostic information. We investigate responses of German health plans to the introduction of morbidity-based risk adjustment in the Statutory Health...

Once a humble, beloved, charity-based arm of the healthcare industry, hospice is now a multi-billion dollar industry, funded almost exclusively by Medicare, run by for-profit corporations answering to private equity investors and Wall Street, and more and more frequently plagued by fraud and...

The Patient Protection and Affordable Care Act of 2010 (“ACA”) requires most Americans to obtain health insurance for themselves and their dependents by 2014. In a recent essay, Professor Douglas Kahn and Professor Jeffrey Kahn take issue with one of several justifications for what has...

Background: Smoking causes higher incidence of certain diseases and greater severity of most health conditions. Smokers and recent quitters have higher health care utilization than never smokers and long-term quitters; as a result, smoking causes an increase in health care costs. This raises the...

This paper examines the tradeoffs of monitoring for wasteful public spending. By penalizing unnecessary spending, monitoring improves the quality of public expenditure and incentivizes firms to invest in compliance technology. I study a large Medicare program that monitored for unnecessary...

Mit dem GKV-Modernisierungsgesetz sollte die GKV-Ausgabenseite auf ein langfristig stabiles Fundament gestellt werden. Für die langfristige Sicherung der GKV-Finanzierungsseite gibt es hauptsächlich zwei alternative Reformkonzepte, nämlich Bürgerversicherungs- und Kopfpauschalenmodelle. Der...

Die private (PKV) und die gesetzliche Krankenversicherung (GKV) werden durch die so genannte Friedensgrenze getrennt. Um die daraus resultierende Risikoselektion zu vermindern, wird die Einführung einer sogenannten Ausscheidegrenze nach niederländischem Vorbild mit Hilfe der...