1,721,098 research outputs found
Amy Finkelstein: 2012 John Bates Clark Medalist
Full text linkAmy Finkelstein is the 2012 recipient of the John Bates Clark Medal from the American Economic Association. The core concerns of Amy's research program have been insurance markets and health care. She has addressed whether asymmetric information leads to inefficiencies in insurance markets, how large social insurance programs affect healthcare markets, and the determinants of innovation incentives in health care. We describe a number of Amy's key research contributions, with particular emphasis on those identified by the Honors and Awards Committee of the American Economic Association in her Clark Medal citation, as well as her broader contributions to the field of economics
Treatment Choice and Outcomes for End Stage Renal Disease: Evidence from the First Year of a Nationwide Randomized Evaluation
No full textPIs: Amy Finkelstein, Yunan Ji, Neale Mahoney, Liran Einav
We plan to analyze the first year of a nationwide randomized-controlled trial of end stage renal disease (ESRD) treatment choice. This mandatory-participation program was designed by the Centers for Medicare and Medicaid Services and randomization was conducted at the hospital referral region (HRR) level. 95 HRRs were assigned to the treatment group beginning in January 2021. We will study the impact of this program in the first year on treatment modality choice for ESRD and explore heterogeneity in impact across patients and providers.
AEA Registration: https://www.socialscienceregistry.org/trials/803
Treatment Choice and Outcomes for End Stage Renal Disease: Evidence from the First Year of a Nationwide Randomized Evaluation
No full textPIs: Amy Finkelstein, Yunan Ji, Neale Mahoney, Liran Einav
We plan to analyze the first year of a nationwide randomized-controlled trial of end stage renal disease (ESRD) treatment choice. This mandatory-participation program was designed by the Centers for Medicare and Medicaid Services and randomization was conducted at the hospital referral region (HRR) level. 95 HRRs were assigned to the treatment group beginning in January 2021. We will study the impact of this program in the first year on treatment modality choice for ESRD and explore heterogeneity in impact across patients and providers.
AEA Registration: https://www.socialscienceregistry.org/trials/803
Treatment Choice and Outcomes for End Stage Renal Disease: Evidence from the First Year of a Nationwide Randomized Evaluation
No full textPIs: Amy Finkelstein, Yunan Ji, Neale Mahoney, Liran Einav
We plan to analyze the first year of a nationwide randomized-controlled trial of end stage renal disease (ESRD) treatment choice. This mandatory-participation program was designed by the Centers for Medicare and Medicaid Services and randomization was conducted at the hospital referral region (HRR) level. 95 HRRs were assigned to the treatment group beginning in January 2021. We will study the impact of this program in the first year on treatment modality choice for ESRD and explore heterogeneity in impact across patients and providers.
AEA Registration: https://www.socialscienceregistry.org/trials/803
The Impact of Medicare Bundled Payments: Evidence from a Nationwide Randomized Evaluation for Lower Extremity Joint Replacement
No full textPIs: Amy Finkelstein, Jonathan Skinner, Neale Mahoney, Yunan Ji
Bundled payments (BP) are a key part of Medicare’s shift away from the traditional fee-for-service (FFS) payment model. We propose to study a nationwide randomized-controlled trial (RCT) of bundled payments for knee and hip replacements that was designed by CMS and launched in April 2016. Randomization was conducted at the Metropolitan Statistical Area (MSA) level with 67 MSAs and about 800 hospitals assigned to the treatment group. We will examine the impact of bundled payments on Medicare spending, utilization, and quality. Our findings should be directly relevant for the design of payments for knee and hip replacements, two common and expensive medical procedures. Average impacts, as well as variation in impact across types of providers and markets may also shed light on economic mechanisms, which should be relevant for bundled payment initiatives under consideration for other medical services.
AEA Registration: https://www.socialscienceregistry.org/trials/252
Insuring Long Term Care In the US
Full text linkLong-term care expenditures constitute one of the largest uninsured financial risks facing the elderly in the United States. This paper provides an overview of the economic and policy issues surrounding insuring long-term care expenditure risk. Through this lens we also discuss the likely impact of recent long-term care public policy initiatives at both the state and federal level.
Selection in Insurance Markets: Theory and Empirics in Pictures
Full text linkWe present a graphical framework for analyzing both theoretical and empirical work on selection in insurance markets. We begin by using this framework to review the “textbook” adverse selection environment and its implications for insurance allocation, social welfare, and public policy. We then discuss several important extensions to this classical treatment that are necessitated by important real world features of insurance markets and which can be easily incorporated in the basic framework. Finally, we use the same graphical approach to discuss the intuition behind recently developed empirical methods for testing for the existence of selection and examining its welfare consequences. We conclude by discussing some important issues that are not well-handled by this framework and which, perhaps not unrelatedly, have been little addressed by the existing empirical work.
Essays on insurance
No full textThesis: Ph. D., Massachusetts Institute of Technology, Department of Economics, 2018.Cataloged from PDF version of thesis.Includes bibliographical references.This thesis consists of three chapters on the economics of health insurance. In the first chapter, Carlos Dobkin, Amy Finkelstein, and Matthew Notowidigdo and I use an event study approach to examine the economic consequences of hospital admissions in two datasets: survey data from the Health and Retirement Study, and hospitalization data linked to credit reports. For non-elderly adults with health insurance, hospital admissions increase out-of-pocket medical spending, unpaid medical bills, and bankruptcy, and reduce earnings, income, access to credit, and consumer borrowing. The earnings decline is substantial compared to the out-of-pocket spending increase, and is minimally insured prior to age-eligibility for Social Security Retirement Income. Relative to the insured non-elderly, the uninsured non-elderly experience much larger increases in unpaid medical bills and bankruptcy rates following a hospital admission. Hospital admissions trigger fewer than 5 percent of all bankruptcies in our sample. In the second chapter, Evan Mast and I investigate an information friction in Medicare Advantage-beneficiaries pay two premiums, and one is much more salient. We find a larger demand elasticity for the salient versus non-salient premium. A model of insurer plan design produces simulated premiums matching the observed distribution using these "behavioral" elasticities, but not when assuming equal elasticities across the two premiums. Removing the friction increases enrollment in low-premium plans, increasing consumer surplus 73/year when including a supply response. In the final chapter, I use difference-in-differences and triple-difference methods to understand the effects of the Affordable Care Act Medicaid expansion on a number of labor supply indicators and find no significant evidence of a labor supply response.by Raymond Kluender.Ph. D
Dynamic Inefficiencies in Insurance Markets: Evidence from long-term care insurance
Full text linkWe examine whether unregulated, private insurance markets efficiently provide insurance against reclassification risk (the risk of becoming a bad risk and facing higher premiums). To do so, we examine the ex-post risk type of individuals who drop their long-term care insurance contracts relative to those who are continually insured. Consistent with dynamic inefficiencies, we find that individuals who drop coverage are of lower risk ex-post than individuals who were otherwise-equivalent at the time of purchase but who do not drop out of their contracts. These findings suggest that dynamic market failures in private insurance markets can preclude the efficient provision of insurance against reclassification risk.
Testing for Asymmetric Information Using 'Unused Observables' in Insurance Markets: Evidence from the U.K. Annuity Market
Full text linkThis paper tests for asymmetric information in the U.K. annuity market of the 1990s by trying to identify 'unused observables,' attributes of individual insurance buyers that are correlated both with subsequent claims experience and with insurance demand but that insurance companies did not use to set insurance prices. Unlike the widely-used positive correlation test for asymmetric information, which searches for a positive correlation between insurance demand and risk experience, the unused observables test is not confounded by heterogeneity in individual preference parameters that may affect insurance demand. We identify residential location as an unused observable in the U.K. annuity market of this period, and show that this variable was correlated both with annuity demand and with prospective mortality. Thus even though residential location was observed by all market participants, the decision not to condition prices on it created the same types of market inefficiencies that arise when annuity buyers have private information about mortality risk. Our findings raise interesting questions about how insurance companies select the set of buyer attributes that they use in setting policy prices. In the decade following the period that we study, U.K. insurance companies changed their pricing practices and began to condition annuity prices on a buyer's postcode.
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