Hospital Network Competition and Adverse Selection: Evidence from the Massachusetts Health Insurance Exchange.
Health insurers increasingly compete on their networks of medical providers. Using data from Massachusetts's insurance exchange, I find substantial adverse selection against plans covering the most prestigious and expensive "star" hospitals. I highlight a theoretically distinct selection channel: co...
| Publicado en: | American Economic Review Vol. 112; no. 2; pp. 578 - 616 |
|---|---|
| Autor principal: | |
| Formato: | Artículo |
| Publicado: |
American Economic Association
Feb2022
|
| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=154928752&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 154928752 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00028282 AER jtl: American Economic Review issn: 00028282 maglogo: N pubinfo: dt: Feb2022 vid: 112 iid: 2 pid: 22 pub: American Economic Association artinfo: ui: 154928752 10.1257/aer.20201453 ppf: 578 ppct: 38 formats: tig: atl: Hospital Network Competition and Adverse Selection: Evidence from the Massachusetts Health Insurance Exchange. aug: au: Shepard, Mark affil: Kennedy School of Government, Harvard University, and NBER su: Massachusetts Health insurance exchanges Insurance exchanges Hospital utilization sug: subj: Massachusetts All Other Insurance Related Activities Health insurance exchanges Insurance exchanges Hospital utilization ab: Health insurers increasingly compete on their networks of medical providers. Using data from Massachusetts's insurance exchange, I find substantial adverse selection against plans covering the most prestigious and expensive "star" hospitals. I highlight a theoretically distinct selection channel: consumers loyal to star hospitals incur high spending, conditional on their medical state, because they use these hospitals' expensive care. This implies heterogeneity in consumers' incremental costs of gaining access to star hospitals, posing a challenge for standard selection policies. Along with selection on unobserved sickness, I find this creates strong incentives to exclude star hospitals, even with risk adjustment in place. (JEL D82, G22, H75, I11, I13, I18) pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
|---|