Financial transaction costs reduce benefit take-up evidence from zero-premium health insurance plans in Colorado

Drake, Coleman; Anderson, David M.; Cai, Sih-Ting; Sacks, Daniel W.

doi:10.1016/j.jhealeco.2023.102752

Cited by 6 publications

(1 citation statement)

References 32 publications

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“…This study examines the historical patterns for a single price position, the least expensive silver plan, over 8 years, and categorizes why and how often different types of changes occur. Payment of any positive sum premiums instead of a zero dollar premium has been associated with substantial administrative burden and enrollment frictions for both the individual health insurance market and Medicaid programs (Dague, 2014; Drake et al, 2023; McIntyre et al, 2021). The passage of the American Rescue Plan Act (ARPA) enhanced subsidies and made zero premium silver plans available to most individuals earning under 150% Federal Poverty Level.…”

Section: Introductionmentioning

confidence: 99%

Dynamic Price Competition for Low-Cost Silver Plans on Healthcare.gov 2014–2021

Ludwinski

Anderson

2023

Med Care Res Rev

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More than 16 million people receive health care coverage through the Affordable Care Act’s (ACA) individual health insurance marketplaces. Many enrollees receive premium subsidies that are tied to the premium of the second least expensive silver plan available. This study investigates the consistency of the least expensive silver plan offered on Healthcare.gov from 2014 to 2021 and finds that on average, from one year to the next, the same insurer offered the least expensive silver plan in 63.1% of counties representing 54.7% of the population. However, even when the same insurer offers the least expensive plan, almost half the time, they introduce a new, less expensive plan in the next policy year. Consequently, ACA enrollees who previously purchased the least expensive silver plan may face incremental premium costs unless they spend time and effort to carefully reevaluate their choices each year. We estimate the potential premium cost of inattention and show how it varies over time and across states.

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Section: Introductionmentioning

confidence: 99%

Dynamic Price Competition for Low-Cost Silver Plans on Healthcare.gov 2014–2021

Ludwinski

Anderson

2023

Med Care Res Rev

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Does outpatient mutual‐aid reduce oncology patients' utilization of inpatient services?—An empirical study of outpatient mutual‐aid policy in Wuhan, China

Jiang,

Zhang,

Bingbing

2024

Health Planning & Management

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BackgroundThe escalating costs of healthcare had prompted countries to undertake reforms, and in recent years China had focused on overhauling its outpatient healthcare system. China implemented the outpatient mutual‐aid policy which had led to a change in the costs associated with outpatient treatment from being fully self‐paid by the patient to being partially self‐paid.PurposeThis study aimed to assess the impact of the outpatient mutual‐aid policy on inpatient services for oncology patients in Wuhan, China, exploring the impact that the cumbersome administration of health insurance would have on patient welfare.Methods24,260 oncology patients of the health insurance reimbursement database in Wuhan spanning from January 2022 to July 2023 were included. After data processing, 12,985 patients were included in the control group and 11,275 patients were included in the experimental group. The regression discontinuity design was employed to assess the impact of the policy.ResultsThe findings was that the implementation of the outpatient mutual‐aid would result in a reduction of 1.2 days in the length of stay for oncology patients, a decrease in hospital costs by 5%, and a decline in expenditure of the health insurance reimbursement funds by 5 per cent.ConclusionsIncorporating outpatient costs into reimbursement supplanted the utilization of inpatient services, enhanced the allocation of healthcare resources, and alleviated the financial burden on oncology patients. Furthermore, it highlighted the detrimental impact of eligibility review to verify that a patient meets the reimbursement requirements of the health insurance policy on patient welfare.

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Capturing and harvesting in Medicare Advantage plan design

Miller

2024

Health Affairs Scholar

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Consumers in health insurance markets have inertia stemming from the desire to maintain relationships with providers and other frictions involved in switching plans. In other markets that feature inertia, suppliers respond with pricing strategies that vary by market share: lowering markups to capture consumers when market shares are low, and raising markups to harvest profits once market share has been established. I tested for this behavior in the Medicare Advantage market by examining how MA plan sponsors changed the financial terms of their plans in response to changes in market share from 2007-2021 using a first-difference model with fixed effects. I found evidence that plans increase premiums, copays, and out-of-pocket limits when market shares increase. The results imply that for every 1% increase in market share, plan sponsors subsequently increase out-of-pocket costs by 1% in the following year.

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Financial transaction costs reduce benefit take-up evidence from zero-premium health insurance plans in Colorado

Cited by 6 publications

References 32 publications

Dynamic Price Competition for Low-Cost Silver Plans on Healthcare.gov 2014–2021

Dynamic Price Competition for Low-Cost Silver Plans on Healthcare.gov 2014–2021

Does outpatient mutual‐aid reduce oncology patients' utilization of inpatient services?—An empirical study of outpatient mutual‐aid policy in Wuhan, China

Capturing and harvesting in Medicare Advantage plan design

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