Unbiased Analysis of Today's Healthcare Issues

Archive for the 'Health Insurance' Category

VBID in practice

In a typical insurance plan, patients have a fixed copayment, insurance and deductible regardless of whether the treatment they receive is considered high or low value.  However, an alternative insurance structure–known as value-based insurance design (VBID)–uses a different approach.  Under VBID, patient cost sharing is higher for low-value treatments and lower or eliminated for high-value […]

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Is P4P doomed to fail?

There have been many pay-for-performance (P4P) programs that have been implemented to attempt to improve quality and reduce cost. The vast majority of these programs have not been able to demonstrate large or even any improvement in quality or cost. Some researchers claim that these programs have not worked due to the size of the […]

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Health insurance in China

Although China has the world’s largest economy, the average individual is actually fairly poor.  Average incomes in the country are less than $15,000 per year, ranking #121 in the world.  However, a vast majority of Chinese have health insurance due to some recent reforms. A paper by Zhang et al. (2016) uses data from the 2011-2012 China […]

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Canada’s single payer system doesn’t cover drugs?

Yes it is true.  Wang et al. (2015) report: Unlike physician and hospital services, which are universal in Canada, coverage for prescription drugs dispensed outside hospitals falls outside the Canada Health Act and provincial governments only provide public drug programs for some population groups,primarily seniors and social assistance recipients…Canada is still the only country that […]

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The cost of allowing kids to remain dependents up to 26 years

Many of the provisions of the Affordable Care Act include provisions requiring health insurers to do certain things.  Variability of premiums are regulated, certain services are mandated (e.g., free annual check-up) and minimum benefits packages are set on the health insurance exchanges.  One seemingly innocuous provision of the ACA is that children are allowed to remain […]

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Physician shortage?

A physician shortage may be a bit much, but it appears that physicians overestimate their availability based on a study by Coffman et al. (2016). The percentage of callers posing as Medicaid patients who could schedule new patient appointments was 18 percentage points lower than the percentage of physicians who self-reported on the survey that […]

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ASSA 2016: Regional variation in hospital spending among U.S. privately insured patients

How do health care costs vary across the country. Although the team at the Dartmouth Atlas has done this exercise with patients in Medicare, there has been less study of region variation in health care spending among the privately insured with the notable exception of a 2013 Institute of Medicine report. In a study by […]

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2016 ASSA: How does competitions among insurers affect premiums

Typically, most economists believe that increased competition decreases prices.  However, is that the case for competition among health insurers? On the one hand, competition among health insurers could decrease prices if consumers choose plans based on premiums.  Competition may increase insurer’s incentive to negotiate with providers and may force insurers to make lower margins or lower […]

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2016 ASSA: Effect of guaranteed issue and community rating on health insurance premiums

How should insurance be regulated? Should insurance plans be able to price premiums based on health conditions? The drawbacks of this approach is that it is not equitable as sicker patients will pay higher premiums. Should all people pay the same cost? Although more equitable, using a single price would incentivize healthy people to avoid […]

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2016 ASSA: How does expanding Medicaid eligibility affect take-up and health care spending?

Typically, answering this question is difficult as the Medicaid program varies across states and even within states. What Amanda Kowalski and co-authors do in a paper she presented at the 2016 ASSA is collect data on the variation in Medicaid eligibility across states, across demographic groups, and across time from the inception of Medicaid in […]

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