scholarly journals Externalities and Taxation of Supplemental Insurance: A Study of Medicare and Medigap

2019 ◽  
Vol 11 (2) ◽  
pp. 37-73 ◽  
Author(s):  
Marika Cabral ◽  
Neale Mahoney
Keyword(s):  
Health Insurance ◽  
Standard Error ◽  
Cost Sharing ◽  
Negative Externality ◽  
Medicare Beneficiaries ◽  
Supplemental Insurance ◽  
Medical Markets ◽  
The Impact ◽  
The Universe ◽  
Medicare Spending

Most health insurance uses cost-sharing to reduce excess utilization. Supplemental insurance can blunt the impact of this cost-sharing, increasing utilization and exerting a negative externality on the primary insurer. This paper estimates the effect of private Medigap supplemental insurance on public Medicare spending using Medigap premium discontinuities in local medical markets that span state boundaries. Using administrative data on the universe of Medicare beneficiaries, we estimate that Medigap increases an individual’s Medicare spending by 22.2 percent. We calculate that a 15 percent tax on Medigap premiums generates savings of $12.9 billion annually with a standard error of $4.9 billion. (JEL G22, H24, H51, I13, J14)

scholarly journals COST-BENEFIT ANALYSIS OF HEARING CARE SERVICES AMONG MEDICARE BENEFICIARIES WITH HEARING AIDS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S43-S44
Author(s):  
Amber Willink ◽  
Amber Willink ◽  
Nicholas S Reed ◽  
Frank R Lin
Keyword(s):  
Older Adults ◽  
Hearing Aids ◽  
Cost Benefit Analysis ◽  
Skilled Nursing Facility ◽  
Medicare Beneficiaries ◽  
Cross Sectional ◽  
Care Services ◽  
Medicare Program ◽  
The Impact ◽  
Medicare Spending

Abstract Hearing care services for older adults with hearing aids are underutilized and are not covered by the Medicare program. Little information exists to the value of hearing care services for older adults with hearing aids. Using the Medicare Current Beneficiary Survey 2013, we conducted a cross-sectional analysis of the impact of hearing care services use on Medicare spending among those with hearing aids. Older Medicare beneficiaries with hearing aids that received hearing care services in the previous 12 months were propensity score matched to those who did not receive services. Average annual Medicare spending was $8196 (CI:$6670-$9723) among Medicare beneficiaries who used hearing care services and $10,709 (CI:$8878-12541) among matched controls. Spending differences were driven by higher skilled nursing facility and home health spending among matched controls. Increasing access to hearing care services among Medicare beneficiaries with hearing aids may provide value to the health care system and Medicare program.

The impact of health insurance cost-sharing method on healthcare utilisation in China

2016 ◽  
Vol 9 (1) ◽  
pp. 38-61 ◽  
Author(s):  
Qin Zhou ◽  
Gordon G. Liu ◽  
Yankun Sun ◽  
Sam A. Vortherms
Keyword(s):  
Health Insurance ◽  
Cost Sharing ◽  
Healthcare Utilisation ◽  
Insurance Cost ◽  
The Impact

scholarly journals An Empirical Model of Medicare Costs: The Role of Health Insurance, Employment, and Delays in Medicare Enrollment

Econometrics ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 25
Author(s):  
Yuanyuan Deng ◽  
Hugo Benítez-Silva
Keyword(s):  
Health Insurance ◽  
Social Insurance ◽  
Insurance Coverage ◽  
Sample Selection ◽  
Health Insurance Coverage ◽  
The United States ◽  
Lower Probability ◽  
Medicare Beneficiaries ◽  
Medicare Costs ◽  
Medicare Spending

Medicare is one of the largest federal social insurance programs in the United States and the secondary payer for Medicare beneficiaries covered by employer-provided health insurance (EPHI). However, an increasing number of individuals are delaying their Medicare enrollment when they first become eligible at age 65. Using administrative data from the Medicare Current Beneficiary Survey (MCBS), this paper estimates the effects of EPHI, employment, and delays in Medicare enrollment on Medicare costs. Given the administrative nature of the data, we are able to disentangle and estimate the Medicare as secondary payer (MSP) effect and the work effects on Medicare costs, as well as to construct delay enrollment indicators. Using Heckman’s sample selection model, we estimate that MSP and being employed are associated with a lower probability of observing positive Medicare spending and a lower level of Medicare spending. This paper quantifies annual savings of $5.37 billion from MSP and being employed. Delays in Medicare enrollment generate additional annual savings of $10.17 billion. Owing to the links between employment, health insurance coverage, and Medicare costs presented in this research, our findings may be of interest to policy makers who should take into account the consequences of reforms on the Medicare system.

Care, Costs, and Health: Reactions to and Reinterpretation of the Rand Findings

PEDIATRICS ◽  
1985 ◽  
Vol 76 (4) ◽  
pp. 614-621
Author(s):  
Barbara Starfield ◽  
Diana Dutton
Keyword(s):  
Health Insurance ◽  
Medical Care ◽  
National Health Insurance ◽  
National Health ◽  
Cost Sharing ◽  
Controlled Trial ◽  
Private Insurance ◽  
Services Research ◽  
The Impact ◽  
Care Costs

The reports of Valdez et al1 and Leibowitz et al2 mark the culmination of a landmark effort. Initiated over a decade ago, the Rand Health Insurance Experiment—the most ambitious and expensive randomized controlled trial ever conducted in health services research—was designed to produce estimates of the costs of various forms of national health insurance. Projected estimates of the costs of Medicaid and Medicare had been far too low and health policy experts hoped to obtain information that would prove closer to the mark in the (then) seemingly likely passage of some form of national health insurance. Although national health insurance has not materialized, the impact of medical care costs on utilization of services and health status is still of great interest. The amount of "cost-sharing" (medical costs paid by patients) has increased dramatically in public insurance programs, and many health policymakers favor increases in private insurance programs. The central question now, however, is how much of the cost burden can be borne by patients without inducing reductions in utilization that are harmful to health. The two papers1,2 in the May issue of Pediatrics reported on the impact of cost-sharing on children's utilization and health. The basic findings were similar to those for adults. In general, the higher the costs paid by families, the fewer the children receiving medical care and the fewer the services per user. The only exception was hospitalization of children aged 5 to 13, which was largely unaffected by cost-sharing; higher costs did appear to reduce hospitalization of younger children, as well as ambulatory care for children of all ages.

scholarly journals Racial and Ethnic Differences in Preventive Services Use After the Affordable Care Act’s Enhancement of Medicare Benefits

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 98-98
Author(s):  
Mohammad Usama Toseef ◽  
Wassim Tarraf
Keyword(s):  
Cost Sharing ◽  
Medical Expenditure Panel Survey ◽  
Ethnic Disparities ◽  
Preventive Services ◽  
Clinical Breast Examination ◽  
Medical Expenditure ◽  
Medicare Beneficiaries ◽  
Racial And Ethnic Differences ◽  
Targeted Interventions ◽  
The Impact

Abstract As a consequence of the Affordable Care Act’s enhancements of Medicare benefits, certain recommended clinical preventive services became available to Medicare beneficiaries without cost-sharing. We study the impact of these mandates on racial/ethnic disparities in the use of preventive services among traditional Medicare beneficiaries. We analyze nationally representative data on non-institutionalized Medicare seniors from the 2006-2016 Medical Expenditure Panel Survey (N=27,124). Our preventive services of interest include yearly receipt of cholesterol check, blood pressure test, flu shot, endoscopy, blood stool test, clinical breast examination, mammography and prostate exam. We estimate propensity score weighted difference-in-difference (DID) models to test for differences in preventive services utilization by race/ethnicity. Among traditional Medicare beneficiaries, we do not observe significant change in the use of most preventive services for Blacks and Hispanics compared to their White counterparts. However, Hispanics have significantly increased their use of blood stool tests relative to whites. Overall, we do not find major evidence to support a differential effect of reforms on race/ethnic minorities’ uptake of preventive services following the mandates. Our results suggest that despite an overall benefit trough services expansion and cost-sharing elimination race/ethnic group differences persist. As such, disparities might continue and would require additional interventions. Reduction in disparities is a stated goal of US policy for many decades and achieving equity might require additional work and more varied and targeted interventions.

scholarly journals Investigating the properties of a galaxy group at z = 0.6

2020 ◽  
Vol 15 (S359) ◽  
pp. 188-189
Author(s):  
Daniela Hiromi Okido ◽  
Cristina Furlanetto ◽  
Marina Trevisan ◽  
Mônica Tergolina
Keyword(s):  
Large Scale ◽  
The Other ◽  
Numerical Density ◽  
Spectroscopy Data ◽  
Stellar Kinematics ◽  
Galaxy Groups ◽  
The Galaxy ◽  
The Difference ◽  
The Impact ◽  
The Universe

AbstractGalaxy groups offer an important perspective on how the large-scale structure of the Universe has formed and evolved, being great laboratories to study the impact of the environment on the evolution of galaxies. We aim to investigate the properties of a galaxy group that is gravitationally lensing HELMS18, a submillimeter galaxy at z = 2.39. We obtained multi-object spectroscopy data using Gemini-GMOS to investigate the stellar kinematics of the central galaxies, determine its members and obtain the mass, radius and the numerical density profile of this group. Our final goal is to build a complete description of this galaxy group. In this work we present an analysis of its two central galaxies: one is an active galaxy with z = 0.59852 ± 0.00007, while the other is a passive galaxy with z = 0.6027 ± 0.0002. Furthermore, the difference between the redshifts obtained using emission and absorption lines indicates an outflow of gas with velocity v = 278.0 ± 34.3 km/s relative to the galaxy.

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