In most US health insurance markets, plans face strong incentives to upcode the patient
diagnoses they report to the regulator, as these affect the risk-adjusted payments that plans …

Health insurers increasingly compete on their networks of medical providers. Using data
from Massachusetts's insurance exchange, I find substantial adverse selection against plans …

Background Payment models for palliative care vary across nations, with few adopting
contemporary payments designs that apply to other parts of the health system. Aim To …

We explore how private drug plans set cost sharing in the context of Medicare Part D. While
publicly provided drug coverage typically involves uniform cost sharing across drugs, we …

We study insurers' use of prescription drug formularies to screen consumers in the ACA
Health Insurance exchanges. We begin by showing that exchange risk adjustment and …

Selection (adverse or advantageous) is the central problem that inhibits the smooth, efficient
functioning of competitive health insurance markets. Even—and perhaps especially—when …

Government programs are often offered on an optional basis to market participants. We
explore the economics of such voluntary regulation in the context of a Medicare payment …

The development of new technologies and big data analytics tools has had a profound
impact on the insurance industry. A new wave of insurance economics research has …

Importance Models predicting health care spending and other outcomes from administrative
records are widely used to manage and pay for health care, despite well-documented …

Health insurance is increasingly provided through managed competition, in which subsidies
for consumers and risk adjustment for insurers are key market design instruments. We …