Testing for selection bias and moral hazard in private health insurance : evidence from a mixed public-private health system
Gespeichert in:
| Autor*in: |
Afoakwah, Clifford [verfasserIn] Byrnes, Joshua [verfasserIn] Scuffham, Paul A. [verfasserIn] Nghiem, Son [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2023 |
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| Schlagwörter: |
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| Übergeordnetes Werk: |
Enthalten in: Health economics - New York, NY : Wiley, 1992, 32(2023), 1 vom: Jan., Seite 3-24 |
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| Übergeordnetes Werk: |
volume:32 ; year:2023 ; number:1 ; month:01 ; pages:3-24 |
| Links: |
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| DOI / URN: |
10.1002/hec.4605 |
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| Katalog-ID: |
1826625089 |
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| 982 | |2 26 |1 00 |x DE-206 |b Separating selection bias from moral hazard in private health insurance (PHI) markets has been a challenging task. We estimate selection bias and moral hazard in Australia's mixed public-private health system, where PHI premiums are community-rated rather than risk-rated. Using longitudinal cohort data, with fine-grained measures for medical services predominantly funded by PHI providers, we find consistent and robust estimates of advantageous selection among hospitalized cardiovascular disease (CVD) patients. Specifically, we show that in addition to their risk-averse attributes, CVD patients who purchase PHI use fewer services that are not covered by PHI providers (e.g., general practitioners and emergency departments) and have fewer comorbidities. Finally, unlike previous studies, we show that ex-post moral hazard exists in the use of specific "in-hospital" medical services such as specialist and physician services, miscellaneous diagnostic procedures, and therapeutic treatments. From the perspective of PHI providers, the annual cost of moral hazard translates to a lower bound estimate of $707 per patient, equivalent to a 3.03% reduction in their annual profits. | ||
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| allfields |
10.1002/hec.4605 doi (DE-627)1826625089 (DE-599)KXP1826625089 DE-627 ger DE-627 rda eng Afoakwah, Clifford verfasserin (DE-588)1245663321 (DE-627)1777371074 aut Testing for selection bias and moral hazard in private health insurance evidence from a mixed public-private health system Clifford Afoakwah, Joshua Byrnes, Paul Scuffham, Son Nghiem 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier cardiovascular disease (dpeaa)DE-206 moral hazard (dpeaa)DE-206 private health insurance (dpeaa)DE-206 selection bias (dpeaa)DE-206 Byrnes, Joshua verfasserin (DE-588)1245663429 (DE-627)1777371171 aut Scuffham, Paul A. verfasserin (DE-588)171302796 (DE-627)06148976X (DE-576)132106612 aut Nghiem, Son verfasserin (DE-588)1019013990 (DE-627)683493701 (DE-576)356780511 aut Enthalten in Health economics New York, NY : Wiley, 1992 32(2023), 1 vom: Jan., Seite 3-24 Online-Ressource (DE-627)300894805 (DE-600)1483261-6 (DE-576)079719066 1099-1050 nnns volume:32 year:2023 number:1 month:01 pages:3-24 https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/hec.4605 Verlag kostenfrei https://doi.org/10.1002/hec.4605 Resolving-System kostenfrei GBV_USEFLAG_U GBV_ILN_26 ISIL_DE-206 SYSFLAG_1 GBV_KXP SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_184 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_266 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 GBV_ILN_2403 GBV_ILN_2403 ISIL_DE-LFER AR 32 2023 1 1 3-24 26 01 0206 4228517188 x1z 08-12-22 2403 01 DE-LFER 4245396512 00 --%%-- --%%-- n --%%-- l01 10-01-23 2403 01 DE-LFER https://doi.org/10.1002/hec.4605 2403 01 DE-LFER https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/hec.4605 26 00 DE-206 Separating selection bias from moral hazard in private health insurance (PHI) markets has been a challenging task. We estimate selection bias and moral hazard in Australia's mixed public-private health system, where PHI premiums are community-rated rather than risk-rated. Using longitudinal cohort data, with fine-grained measures for medical services predominantly funded by PHI providers, we find consistent and robust estimates of advantageous selection among hospitalized cardiovascular disease (CVD) patients. Specifically, we show that in addition to their risk-averse attributes, CVD patients who purchase PHI use fewer services that are not covered by PHI providers (e.g., general practitioners and emergency departments) and have fewer comorbidities. Finally, unlike previous studies, we show that ex-post moral hazard exists in the use of specific "in-hospital" medical services such as specialist and physician services, miscellaneous diagnostic procedures, and therapeutic treatments. From the perspective of PHI providers, the annual cost of moral hazard translates to a lower bound estimate of $707 per patient, equivalent to a 3.03% reduction in their annual profits. |
| spelling |
10.1002/hec.4605 doi (DE-627)1826625089 (DE-599)KXP1826625089 DE-627 ger DE-627 rda eng Afoakwah, Clifford verfasserin (DE-588)1245663321 (DE-627)1777371074 aut Testing for selection bias and moral hazard in private health insurance evidence from a mixed public-private health system Clifford Afoakwah, Joshua Byrnes, Paul Scuffham, Son Nghiem 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier cardiovascular disease (dpeaa)DE-206 moral hazard (dpeaa)DE-206 private health insurance (dpeaa)DE-206 selection bias (dpeaa)DE-206 Byrnes, Joshua verfasserin (DE-588)1245663429 (DE-627)1777371171 aut Scuffham, Paul A. verfasserin (DE-588)171302796 (DE-627)06148976X (DE-576)132106612 aut Nghiem, Son verfasserin (DE-588)1019013990 (DE-627)683493701 (DE-576)356780511 aut Enthalten in Health economics New York, NY : Wiley, 1992 32(2023), 1 vom: Jan., Seite 3-24 Online-Ressource (DE-627)300894805 (DE-600)1483261-6 (DE-576)079719066 1099-1050 nnns volume:32 year:2023 number:1 month:01 pages:3-24 https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/hec.4605 Verlag kostenfrei https://doi.org/10.1002/hec.4605 Resolving-System kostenfrei GBV_USEFLAG_U GBV_ILN_26 ISIL_DE-206 SYSFLAG_1 GBV_KXP SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_184 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_266 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 GBV_ILN_2403 GBV_ILN_2403 ISIL_DE-LFER AR 32 2023 1 1 3-24 26 01 0206 4228517188 x1z 08-12-22 2403 01 DE-LFER 4245396512 00 --%%-- --%%-- n --%%-- l01 10-01-23 2403 01 DE-LFER https://doi.org/10.1002/hec.4605 2403 01 DE-LFER https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/hec.4605 26 00 DE-206 Separating selection bias from moral hazard in private health insurance (PHI) markets has been a challenging task. We estimate selection bias and moral hazard in Australia's mixed public-private health system, where PHI premiums are community-rated rather than risk-rated. Using longitudinal cohort data, with fine-grained measures for medical services predominantly funded by PHI providers, we find consistent and robust estimates of advantageous selection among hospitalized cardiovascular disease (CVD) patients. Specifically, we show that in addition to their risk-averse attributes, CVD patients who purchase PHI use fewer services that are not covered by PHI providers (e.g., general practitioners and emergency departments) and have fewer comorbidities. Finally, unlike previous studies, we show that ex-post moral hazard exists in the use of specific "in-hospital" medical services such as specialist and physician services, miscellaneous diagnostic procedures, and therapeutic treatments. From the perspective of PHI providers, the annual cost of moral hazard translates to a lower bound estimate of $707 per patient, equivalent to a 3.03% reduction in their annual profits. |
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10.1002/hec.4605 doi (DE-627)1826625089 (DE-599)KXP1826625089 DE-627 ger DE-627 rda eng Afoakwah, Clifford verfasserin (DE-588)1245663321 (DE-627)1777371074 aut Testing for selection bias and moral hazard in private health insurance evidence from a mixed public-private health system Clifford Afoakwah, Joshua Byrnes, Paul Scuffham, Son Nghiem 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier cardiovascular disease (dpeaa)DE-206 moral hazard (dpeaa)DE-206 private health insurance (dpeaa)DE-206 selection bias (dpeaa)DE-206 Byrnes, Joshua verfasserin (DE-588)1245663429 (DE-627)1777371171 aut Scuffham, Paul A. verfasserin (DE-588)171302796 (DE-627)06148976X (DE-576)132106612 aut Nghiem, Son verfasserin (DE-588)1019013990 (DE-627)683493701 (DE-576)356780511 aut Enthalten in Health economics New York, NY : Wiley, 1992 32(2023), 1 vom: Jan., Seite 3-24 Online-Ressource (DE-627)300894805 (DE-600)1483261-6 (DE-576)079719066 1099-1050 nnns volume:32 year:2023 number:1 month:01 pages:3-24 https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/hec.4605 Verlag kostenfrei https://doi.org/10.1002/hec.4605 Resolving-System kostenfrei GBV_USEFLAG_U GBV_ILN_26 ISIL_DE-206 SYSFLAG_1 GBV_KXP SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_184 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_266 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 GBV_ILN_2403 GBV_ILN_2403 ISIL_DE-LFER AR 32 2023 1 1 3-24 26 01 0206 4228517188 x1z 08-12-22 2403 01 DE-LFER 4245396512 00 --%%-- --%%-- n --%%-- l01 10-01-23 2403 01 DE-LFER https://doi.org/10.1002/hec.4605 2403 01 DE-LFER https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/hec.4605 26 00 DE-206 Separating selection bias from moral hazard in private health insurance (PHI) markets has been a challenging task. We estimate selection bias and moral hazard in Australia's mixed public-private health system, where PHI premiums are community-rated rather than risk-rated. Using longitudinal cohort data, with fine-grained measures for medical services predominantly funded by PHI providers, we find consistent and robust estimates of advantageous selection among hospitalized cardiovascular disease (CVD) patients. Specifically, we show that in addition to their risk-averse attributes, CVD patients who purchase PHI use fewer services that are not covered by PHI providers (e.g., general practitioners and emergency departments) and have fewer comorbidities. Finally, unlike previous studies, we show that ex-post moral hazard exists in the use of specific "in-hospital" medical services such as specialist and physician services, miscellaneous diagnostic procedures, and therapeutic treatments. From the perspective of PHI providers, the annual cost of moral hazard translates to a lower bound estimate of $707 per patient, equivalent to a 3.03% reduction in their annual profits. |
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10.1002/hec.4605 doi (DE-627)1826625089 (DE-599)KXP1826625089 DE-627 ger DE-627 rda eng Afoakwah, Clifford verfasserin (DE-588)1245663321 (DE-627)1777371074 aut Testing for selection bias and moral hazard in private health insurance evidence from a mixed public-private health system Clifford Afoakwah, Joshua Byrnes, Paul Scuffham, Son Nghiem 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier cardiovascular disease (dpeaa)DE-206 moral hazard (dpeaa)DE-206 private health insurance (dpeaa)DE-206 selection bias (dpeaa)DE-206 Byrnes, Joshua verfasserin (DE-588)1245663429 (DE-627)1777371171 aut Scuffham, Paul A. verfasserin (DE-588)171302796 (DE-627)06148976X (DE-576)132106612 aut Nghiem, Son verfasserin (DE-588)1019013990 (DE-627)683493701 (DE-576)356780511 aut Enthalten in Health economics New York, NY : Wiley, 1992 32(2023), 1 vom: Jan., Seite 3-24 Online-Ressource (DE-627)300894805 (DE-600)1483261-6 (DE-576)079719066 1099-1050 nnns volume:32 year:2023 number:1 month:01 pages:3-24 https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/hec.4605 Verlag kostenfrei https://doi.org/10.1002/hec.4605 Resolving-System kostenfrei GBV_USEFLAG_U GBV_ILN_26 ISIL_DE-206 SYSFLAG_1 GBV_KXP SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_184 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_266 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 GBV_ILN_2403 GBV_ILN_2403 ISIL_DE-LFER AR 32 2023 1 1 3-24 26 01 0206 4228517188 x1z 08-12-22 2403 01 DE-LFER 4245396512 00 --%%-- --%%-- n --%%-- l01 10-01-23 2403 01 DE-LFER https://doi.org/10.1002/hec.4605 2403 01 DE-LFER https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/hec.4605 26 00 DE-206 Separating selection bias from moral hazard in private health insurance (PHI) markets has been a challenging task. We estimate selection bias and moral hazard in Australia's mixed public-private health system, where PHI premiums are community-rated rather than risk-rated. Using longitudinal cohort data, with fine-grained measures for medical services predominantly funded by PHI providers, we find consistent and robust estimates of advantageous selection among hospitalized cardiovascular disease (CVD) patients. Specifically, we show that in addition to their risk-averse attributes, CVD patients who purchase PHI use fewer services that are not covered by PHI providers (e.g., general practitioners and emergency departments) and have fewer comorbidities. Finally, unlike previous studies, we show that ex-post moral hazard exists in the use of specific "in-hospital" medical services such as specialist and physician services, miscellaneous diagnostic procedures, and therapeutic treatments. From the perspective of PHI providers, the annual cost of moral hazard translates to a lower bound estimate of $707 per patient, equivalent to a 3.03% reduction in their annual profits. |
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10.1002/hec.4605 doi (DE-627)1826625089 (DE-599)KXP1826625089 DE-627 ger DE-627 rda eng Afoakwah, Clifford verfasserin (DE-588)1245663321 (DE-627)1777371074 aut Testing for selection bias and moral hazard in private health insurance evidence from a mixed public-private health system Clifford Afoakwah, Joshua Byrnes, Paul Scuffham, Son Nghiem 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier cardiovascular disease (dpeaa)DE-206 moral hazard (dpeaa)DE-206 private health insurance (dpeaa)DE-206 selection bias (dpeaa)DE-206 Byrnes, Joshua verfasserin (DE-588)1245663429 (DE-627)1777371171 aut Scuffham, Paul A. verfasserin (DE-588)171302796 (DE-627)06148976X (DE-576)132106612 aut Nghiem, Son verfasserin (DE-588)1019013990 (DE-627)683493701 (DE-576)356780511 aut Enthalten in Health economics New York, NY : Wiley, 1992 32(2023), 1 vom: Jan., Seite 3-24 Online-Ressource (DE-627)300894805 (DE-600)1483261-6 (DE-576)079719066 1099-1050 nnns volume:32 year:2023 number:1 month:01 pages:3-24 https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/hec.4605 Verlag kostenfrei https://doi.org/10.1002/hec.4605 Resolving-System kostenfrei GBV_USEFLAG_U GBV_ILN_26 ISIL_DE-206 SYSFLAG_1 GBV_KXP SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_184 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_266 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 GBV_ILN_2403 GBV_ILN_2403 ISIL_DE-LFER AR 32 2023 1 1 3-24 26 01 0206 4228517188 x1z 08-12-22 2403 01 DE-LFER 4245396512 00 --%%-- --%%-- n --%%-- l01 10-01-23 2403 01 DE-LFER https://doi.org/10.1002/hec.4605 2403 01 DE-LFER https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/hec.4605 26 00 DE-206 Separating selection bias from moral hazard in private health insurance (PHI) markets has been a challenging task. We estimate selection bias and moral hazard in Australia's mixed public-private health system, where PHI premiums are community-rated rather than risk-rated. Using longitudinal cohort data, with fine-grained measures for medical services predominantly funded by PHI providers, we find consistent and robust estimates of advantageous selection among hospitalized cardiovascular disease (CVD) patients. Specifically, we show that in addition to their risk-averse attributes, CVD patients who purchase PHI use fewer services that are not covered by PHI providers (e.g., general practitioners and emergency departments) and have fewer comorbidities. Finally, unlike previous studies, we show that ex-post moral hazard exists in the use of specific "in-hospital" medical services such as specialist and physician services, miscellaneous diagnostic procedures, and therapeutic treatments. From the perspective of PHI providers, the annual cost of moral hazard translates to a lower bound estimate of $707 per patient, equivalent to a 3.03% reduction in their annual profits. |
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We estimate selection bias and moral hazard in Australia's mixed public-private health system, where PHI premiums are community-rated rather than risk-rated. Using longitudinal cohort data, with fine-grained measures for medical services predominantly funded by PHI providers, we find consistent and robust estimates of advantageous selection among hospitalized cardiovascular disease (CVD) patients. Specifically, we show that in addition to their risk-averse attributes, CVD patients who purchase PHI use fewer services that are not covered by PHI providers (e.g., general practitioners and emergency departments) and have fewer comorbidities. Finally, unlike previous studies, we show that ex-post moral hazard exists in the use of specific "in-hospital" medical services such as specialist and physician services, miscellaneous diagnostic procedures, and therapeutic treatments. From the perspective of PHI providers, the annual cost of moral hazard translates to a lower bound estimate of $707 per patient, equivalent to a 3.03% reduction in their annual profits.</subfield></datafield></record></collection>
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26 00 DE-206 Separating selection bias from moral hazard in private health insurance (PHI) markets has been a challenging task. We estimate selection bias and moral hazard in Australia's mixed public-private health system, where PHI premiums are community-rated rather than risk-rated. Using longitudinal cohort data, with fine-grained measures for medical services predominantly funded by PHI providers, we find consistent and robust estimates of advantageous selection among hospitalized cardiovascular disease (CVD) patients. Specifically, we show that in addition to their risk-averse attributes, CVD patients who purchase PHI use fewer services that are not covered by PHI providers (e.g., general practitioners and emergency departments) and have fewer comorbidities. Finally, unlike previous studies, we show that ex-post moral hazard exists in the use of specific "in-hospital" medical services such as specialist and physician services, miscellaneous diagnostic procedures, and therapeutic treatments. From the perspective of PHI providers, the annual cost of moral hazard translates to a lower bound estimate of $707 per patient, equivalent to a 3.03% reduction in their annual profits Testing for selection bias and moral hazard in private health insurance evidence from a mixed public-private health system Clifford Afoakwah, Joshua Byrnes, Paul Scuffham, Son Nghiem cardiovascular disease (dpeaa)DE-206 moral hazard (dpeaa)DE-206 private health insurance (dpeaa)DE-206 selection bias (dpeaa)DE-206 |
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misc cardiovascular disease misc moral hazard misc private health insurance misc selection bias |
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Testing for selection bias and moral hazard in private health insurance evidence from a mixed public-private health system Clifford Afoakwah, Joshua Byrnes, Paul Scuffham, Son Nghiem |
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ind1=" " ind2=" "><subfield code="a">GBV_ILN_4336</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4338</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4393</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4700</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2403</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2403</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">ISIL_DE-LFER</subfield></datafield><datafield tag="951" ind1=" " ind2=" "><subfield code="a">AR</subfield></datafield><datafield tag="952" ind1=" " ind2=" "><subfield code="d">32</subfield><subfield code="j">2023</subfield><subfield code="e">1</subfield><subfield code="c">1</subfield><subfield code="h">3-24</subfield></datafield><datafield tag="980" ind1=" " ind2=" "><subfield code="2">26</subfield><subfield code="1">01</subfield><subfield code="x">0206</subfield><subfield code="b">4228517188</subfield><subfield code="y">x1z</subfield><subfield code="z">08-12-22</subfield></datafield><datafield tag="980" ind1=" " ind2=" "><subfield code="2">2403</subfield><subfield code="1">01</subfield><subfield code="x">DE-LFER</subfield><subfield code="b">4245396512</subfield><subfield code="c">00</subfield><subfield code="f">--%%--</subfield><subfield code="d">--%%--</subfield><subfield code="e">n</subfield><subfield code="j">--%%--</subfield><subfield code="y">l01</subfield><subfield code="z">10-01-23</subfield></datafield><datafield tag="981" ind1=" " ind2=" "><subfield code="2">2403</subfield><subfield code="1">01</subfield><subfield code="x">DE-LFER</subfield><subfield code="r">https://doi.org/10.1002/hec.4605</subfield></datafield><datafield tag="981" ind1=" " ind2=" "><subfield code="2">2403</subfield><subfield code="1">01</subfield><subfield code="x">DE-LFER</subfield><subfield code="r">https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/hec.4605</subfield></datafield><datafield tag="982" ind1=" " ind2=" "><subfield code="2">26</subfield><subfield code="1">00</subfield><subfield code="x">DE-206</subfield><subfield code="b">Separating selection bias from moral hazard in private health insurance (PHI) markets has been a challenging task. We estimate selection bias and moral hazard in Australia's mixed public-private health system, where PHI premiums are community-rated rather than risk-rated. Using longitudinal cohort data, with fine-grained measures for medical services predominantly funded by PHI providers, we find consistent and robust estimates of advantageous selection among hospitalized cardiovascular disease (CVD) patients. Specifically, we show that in addition to their risk-averse attributes, CVD patients who purchase PHI use fewer services that are not covered by PHI providers (e.g., general practitioners and emergency departments) and have fewer comorbidities. Finally, unlike previous studies, we show that ex-post moral hazard exists in the use of specific "in-hospital" medical services such as specialist and physician services, miscellaneous diagnostic procedures, and therapeutic treatments. From the perspective of PHI providers, the annual cost of moral hazard translates to a lower bound estimate of $707 per patient, equivalent to a 3.03% reduction in their annual profits.</subfield></datafield></record></collection>
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7.3993244 |