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...

Die Vorschläge der Monopolkommission zur Ausweitung des Wettbewerbs um Bestandskunden in der Privaten Krankenversicherung (PKV) sowie die daran geäußerte Kritik werden vorgestellt und einer Analyse unterzogen. Es wird deutlich, dass die Übertragbarkeit einer risikogerechten Alterungsr...

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...

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...

This paper exploits a sharp reduction in patient cost sharing at age 70 in Japan, using a regression discontinuity design to examine its effect on utilization, health, and financial risk arising from out-of-pocket expenditures. Due to the national policy, cost sharing is 60–80 percent lower at...