insurance selection bias

Summary

Summary: Adverse of favorable selection bias exhibited by insurers or enrollees resulting in disproportionate enrollment of certain groups of people.

Top Publications

  1. ncbi Life insurance and breast cancer risk assessment: adverse selection, genetic testing decisions, and discrimination
    Katrina Armstrong
    Department of Medicine, University of Pennsylvania School of Medicine, USA
    Am J Med Genet A 120:359-64. 2003
  2. pmc Psychosocial impact of breast/ovarian (BRCA1/2) cancer-predictive genetic testing in a UK multi-centre clinical cohort
    M Watson
    Department of Psychological Medicine, Royal Marsden NHS Foundation Trust, London and Sutton, SM2 5PT, England
    Br J Cancer 91:1787-94. 2004
  3. ncbi Risk adjustment and risk selection in Europe: 6 years later
    Wynand P M M van de Ven
    Department of Health Policy and Management, Erasmus University Rotterdam, The Netherlands
    Health Policy 83:162-79. 2007
  4. pmc Favorable selection in the Medicare+Choice program: new evidence
    L M Greenwald
    Office of Strategic Planning, Health Care Financing Administration, Baltimore 21244, MD, USA
    Health Care Financ Rev 21:127-34. 2000
  5. pmc Obtaining insurance after DNA diagnostics: a survey among hypertrophic cardiomyopathy mutation carriers
    Imke Christiaans
    Department of Cardiology, Academic Medical Centre, Amsterdam, The Netherlands
    Eur J Hum Genet 18:251-3. 2010
  6. ncbi Human genetics. A rational view of insurance and genetic discrimination
    William Nowlan
    National Life Insurance Company, Montpelier, VT 05604, USA
    Science 297:195-6. 2002
  7. ncbi Genetic screening for iron overload: No evidence of discrimination at 1 year
    Mark A Hall
    Wake Forest University Medical School, Department of Public Health Sciences, 2000 West 1st Street, Winston Salem, NC 27157 1063, USA
    J Fam Pract 56:829-34. 2007
  8. ncbi Investigating genetic discrimination in the Australian life insurance sector: the use of genetic test results in underwriting, 1999-2003
    Margaret Otlowski
    Centre for Law and Genetics, Faculty of Law, Private Bag 89, University of Tasmania, Hobart, TAS 7000, Australia
    J Law Med 14:367-96. 2007
  9. ncbi Medical care use and selection in a social health insurance with an equalization fund: evidence from Colombia
    Antonio J Trujillo
    College of Health and Public Affairs, University of Central Florida, USA
    Health Econ 12:231-46. 2003
  10. ncbi Insurance, unfair discrimination, and genetic testing
    Patrick J Morrison
    Department of Medical Genetics, Belfast City Hospital Trust, Belfast BT9 7AB, UK
    Lancet 366:877-80. 2005

Detail Information

Publications162 found, 100 shown here

  1. ncbi Life insurance and breast cancer risk assessment: adverse selection, genetic testing decisions, and discrimination
    Katrina Armstrong
    Department of Medicine, University of Pennsylvania School of Medicine, USA
    Am J Med Genet A 120:359-64. 2003
    ..Although fear of insurance discrimination is associated with the decision not to undergo BRCA1/2 testing, there was no evidence of actual insurance discrimination from BRCA1/2 testing...
  2. pmc Psychosocial impact of breast/ovarian (BRCA1/2) cancer-predictive genetic testing in a UK multi-centre clinical cohort
    M Watson
    Department of Psychological Medicine, Royal Marsden NHS Foundation Trust, London and Sutton, SM2 5PT, England
    Br J Cancer 91:1787-94. 2004
    ..The data show persistent worry in younger female gene carriers and confirm changes in risk management consistent with carrier status. Men were not adversely affected by genetic testing in terms of their general mental health...
  3. ncbi Risk adjustment and risk selection in Europe: 6 years later
    Wynand P M M van de Ven
    Department of Health Policy and Management, Erasmus University Rotterdam, The Netherlands
    Health Policy 83:162-79. 2007
    ..Without good risk adjustment the disadvantages of a competitive insurance market may outweigh its advantages...
  4. pmc Favorable selection in the Medicare+Choice program: new evidence
    L M Greenwald
    Office of Strategic Planning, Health Care Financing Administration, Baltimore 21244, MD, USA
    Health Care Financ Rev 21:127-34. 2000
    ..The most striking differences are found in the comparison of average risk factors, indicating a clear bias in the managed care populations toward beneficiaries predicted to be less costly...
  5. pmc Obtaining insurance after DNA diagnostics: a survey among hypertrophic cardiomyopathy mutation carriers
    Imke Christiaans
    Department of Cardiology, Academic Medical Centre, Amsterdam, The Netherlands
    Eur J Hum Genet 18:251-3. 2010
    ....
  6. ncbi Human genetics. A rational view of insurance and genetic discrimination
    William Nowlan
    National Life Insurance Company, Montpelier, VT 05604, USA
    Science 297:195-6. 2002
  7. ncbi Genetic screening for iron overload: No evidence of discrimination at 1 year
    Mark A Hall
    Wake Forest University Medical School, Department of Public Health Sciences, 2000 West 1st Street, Winston Salem, NC 27157 1063, USA
    J Fam Pract 56:829-34. 2007
    ..This study measured the extent of insurance and employment problems associated with population screening for hereditary hemochromatosis and iron overload...
  8. ncbi Investigating genetic discrimination in the Australian life insurance sector: the use of genetic test results in underwriting, 1999-2003
    Margaret Otlowski
    Centre for Law and Genetics, Faculty of Law, Private Bag 89, University of Tasmania, Hobart, TAS 7000, Australia
    J Law Med 14:367-96. 2007
    ..Whilst underwriting in most cases appeared to be reasonable, the article highlights several cases involving disclosure of a positive predictive test result for breast/ovarian cancer that required further investigation...
  9. ncbi Medical care use and selection in a social health insurance with an equalization fund: evidence from Colombia
    Antonio J Trujillo
    College of Health and Public Affairs, University of Central Florida, USA
    Health Econ 12:231-46. 2003
    ..On the other hand, the evidence on selection is somewhat mixed: individuals who report good health status are more likely to participate in SHIEF, while those without a chronic condition are less likely to participate in SHIEF...
  10. ncbi Insurance, unfair discrimination, and genetic testing
    Patrick J Morrison
    Department of Medical Genetics, Belfast City Hospital Trust, Belfast BT9 7AB, UK
    Lancet 366:877-80. 2005
  11. pmc Predictive genetic testing for BRCA1/2 in a UK clinical cohort: three-year follow-up
    C Foster
    Macmillan Research Unit, School of Nursing and Midwifery, University of Southampton, Southampton, UK
    Br J Cancer 96:718-24. 2007
    ....
  12. ncbi HMO marketing and selection bias: are TEFRA HMOs skimming?
    R Lichtenstein
    Department of Health Services Management and Policy, School of Public Health, University of Michigan, Ann Arbor 48109
    Med Care 30:329-46. 1992
    ..It also appears unlikely that HMOs were differentially targeting healthy and unhealthy segments of the Medicare market...
  13. pmc Selection experiences in Medicare HMOs: pre-enrollment expenditures
    K T Call
    University of Minnesota, USA
    Health Care Financ Rev 20:197-209. 1999
    ..Among short-term enrollees, we find unfavorable selection, however, selection bias was not sensitive to market characteristics...
  14. ncbi Switching costs, price sensitivity and health plan choice
    Bruce A Strombom
    Analysis Group Economics Inc, Los Angelus, CA 90017, USA
    J Health Econ 21:89-116. 2002
    ..Simulations combining our results with actuarial data illustrate the cost implications of risk-related differences in price elasticity...
  15. pmc Patient protection and risk selection: do primary care physicians encourage their patients to join or avoid capitated health plans according to the patient's health status?
    Matthew K Wynia
    Institute for Ethics, American Medical Association, Chicago Ill, USA
    J Gen Intern Med 17:40-7. 2002
    ..Though insurance risk selection has been well documented among organizations paid on a prospective basis, such physician-level risk selection has not been studied...
  16. ncbi Premium variation in the individual health insurance market
    B Herring
    Institute for Social and Policy Studies, Yale University, 89 Trumbull Street, New Haven, CT 06520, USA
    Int J Health Care Finance Econ 1:43-58. 2001
    ..We find that premiums vary significantly less strongly with risk for persons insured by HMOs and in markets dominated by managed care insurers...
  17. ncbi The effect of health on acute care supplemental insurance ownership: an empirical analysis
    A Shmueli
    The Hebrew University and the Gertner Institute for Health Policy Research, Jerusalem, Israel
    Health Econ 10:341-50. 2001
    ..The policy implications of the above findings are discussed in the context of the Israeli health system...
  18. ncbi Disenrollment from Medicare HMOs
    K T Call
    Division of Health Services Research and Policy, School of Public Health, University of Minnesota, Box 729 Mayo, 420 Delaware Street SE, Minneapolis, MN 55455, USA
    Am J Manag Care 7:37-51. 2001
    ....
  19. pmc No exit? The effect of health status on dissatisfaction and disenrollment from health plans
    M Schlesinger
    Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT 06520, USA
    Health Serv Res 34:547-76. 1999
    ..To examine the implications of serious and chronic health problems on the willingness of enrollees to switch health plans if they are dissatisfied with their current arrangements...
  20. ncbi Genetic discrimination: perspectives of consumers
    E V Lapham
    Georgetown University Child Development Center, 3307 M Street, NW, Washington, DC, 20007 3935
    Science 274:621-4. 1996
    ..The level of perceived discrimination points to the need for more information to determine the extent and scope of the problem...
  21. ncbi Verification of consumers' experiences and perceptions of genetic discrimination and its impact on utilization of genetic testing
    Kristine Barlow-Stewart
    Centre for Genetics Education, NSW Health, Royal North Shore Hospital, St Leonards, NSW 2065, Australia
    Genet Med 11:193-201. 2009
    ..To undertake a systematic process of verification of consumer accounts of alleged genetic discrimination...
  22. ncbi Choice of health insurance by families of the mentally ill
    P Deb
    Indiana University Purdue University at Indianapolis, USA
    Health Econ 5:61-76. 1996
    ....
  23. ncbi Supplementary health insurance as a tool for risk-selection in mandatory basic health insurance markets
    Francesco Paolucci
    Department of Health Policy and Management, Erasmus University Rotterdam, The Netherlands
    Health Econ Policy Law 2:173-92. 2007
    ..Finally, we discuss several strategies for policy makers to reduce the chance that SI will be used for risk-selection in BI markets...
  24. ncbi Selection bias in TEFRA at-risk HMOs
    R Lichtenstein
    Department of Health Services Management and Policy, School of Public Health, University of Michigan, Ann Arbor 48109
    Med Care 29:318-31. 1991
    ..Evidence suggests that beneficiary self-selection is probably a more important explanation of these patterns than purposeful actions of HMOs to discourage enrollment by sicker beneficiaries (i.e., "skimming")...
  25. ncbi Duplicate coverage and demand for health care. The case of Catalonia
    A M Vera-Hernández
    Department of Economics and Economic History, Universitat Autonoma de Barcelona, Barcelona, Spain
    Health Econ 8:579-98. 1999
    ..It is argued that this last result is related to the existence of a compulsory public insurance...
  26. ncbi Needs for further improvement: risk adjustment in the German health insurance system
    Florian Buchner
    Munich Re, 107 Koeniginstrasse, 80791 Munich, Germany
    Health Policy 65:21-35. 2003
    ..Another cause of risk selection is regional differences. The central suggestion of an expertise on behalf of the German Ministry of Health on experiences and improvement proposals is the change to a direct modeling of morbidity...
  27. ncbi Risk adjusted premium subsidies and risk sharing: key elements of the competitive sickness fund market in the Netherlands
    Leida M Lamers
    Department of Health Policy and Management, Erasmus University Rotterdam, PO Box 17, 38, 3000 DR Rotterdam, The Netherlands
    Health Policy 65:49-62. 2003
    ..The effects of introducing financial risk for Dutch sickness funds on risk selection and consumer mobility are analysed. The paper concludes with a description of expected future developments...
  28. ncbi Risk adjustment in Switzerland
    Konstantin Beck
    Department of Statistics, PO Box 2568, CH 6002, Lucerne, Switzerland
    Health Policy 65:63-74. 2003
    ..The paper concludes with a description of the current political and scientific discussion in Switzerland...
  29. ncbi Options and opportunities for individuals and families in the private health insurance market
    Janet Stokes Trautwein
    National Association of Health Underwriters, Arlington, Virginia, USA
    Health Aff (Millwood) . 2002
    ..Since individual-market purchasers do not have an employer contribution to offset the cost of coverage, proposals for refundable tax credits offer great potential for making health insurance coverage more affordable for eligible persons...
  30. ncbi Risk selection and complementary health insurance: the Swiss approach
    Mathias Kifmann
    Universitat Augsburg, Universitätsstr 16, 86159 Augsburg, Germany
    Int J Health Care Finance Econ 6:151-70. 2006
    ..Nevertheless, the integration approach can be Pareto-superior if the cost savings due to the integration of basic and complementary insurance are sufficiently large...
  31. ncbi Do adjusted clinical groups eliminate incentives for HMOs to avoid substance abusers? Evidence from the Maryland Medicaid HealthChoice program
    Susan L Ettner
    UCLA Department of Medicine, Division of General Internal Medicine and Health Services Research, 911 Broxton Plaza, Room 106, Box 951736, Los Angeles, CA 90095 1736, USA
    J Behav Health Serv Res 30:63-77. 2003
    ..Thus, the adjusted clinical groups methodology used to adjust capitation payments in the HealthChoice program attenuated, but did not eliminate, financial incentives for MCOs to avoid substance abusers...
  32. ncbi Evaluating selection out of health plans for Medicaid beneficiaries with substance abuse
    Sharon Lise T Normand
    Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA 02115, USA
    J Behav Health Serv Res 30:78-92. 2003
    ..These results suggest that current risk-adjustment systems may fail to offset selection incentives in modern capitated health plans...
  33. ncbi Adverse selection and generosity of alcohol treatment benefits
    Katherine M Harris
    Division of Clinical and Prevention Research, National Institute on Alcohol Abuse and Alcoholism NIAAA, Rockville, MD 20852, USA
    Inquiry 39:413-28. 2002
    ..Also, users of alcohol treatment services do not remain disproportionately enrolled longer in plans with generous benefits...
  34. ncbi How does the employer contribution for the federal employees health benefits program influence plan selection?
    Curtis S Florence
    Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, USA
    Health Aff (Millwood) 22:211-8. 2003
    ..We find that there is little risk segmentation in the FEHBP and that reducing the premium subsidy would lower government premium spending and slightly increase risk segmentation...
  35. ncbi Cream-skimming, incentives for efficiency and payment system
    Pedro Pita Barros
    Faculdade de Economia, Universidade Nova de Lisboa, Travessa Estêvão Pinto, P 1099 032 Lisboa, Portugal
    J Health Econ 22:419-43. 2003
    ..It can be interpreted as a fixed transfer in the beginning of the period plus an ex-post fund at the end of the period. The novelty rests in the way contributions to this fund are defined...
  36. ncbi Guaranteed renewability and the problem of risk variation in individual health insurance markets
    Vip Patel
    eHealthInsurance Inc, Sunnyvale, California, USA
    Health Aff (Millwood) . 2002
    ..The paper concludes with a discussion of possible threats to the protection guaranteed renewability provides against risk segmentation...
  37. ncbi Using tax credits and state high-risk pools to expand health insurance coverage
    Bruce Abbe
    Communicating for Agriculture and the Self Employed, USA
    Health Aff (Millwood) . 2002
    ....
  38. ncbi The nongroup market as one element of a broader coverage-expansion strategy
    Laura Tollen
    Kaiser Permanente Institute for Health Policy, Kaiser Foundation Health Plan, Inc, Oakland, California, USA
    Health Aff (Millwood) . 2002
    ..In "more regulated" markets, a broadly funded reinsurance mechanism could moderate premiums...
  39. ncbi Has solidarity survived? A comparative analysis of the effect of social health insurance reform in four European countries
    Hans Maarse
    Faculty of Health Sciences, University of Maastricht
    J Health Polit Policy Law 28:585-614. 2003
    ..g., an increase in private payments), accompanying measures often were taken to keep solidarity intact as much as possible. Thus the assumption of a negative impact as a result of health insurance reform is not confirmed...
  40. ncbi Aboard the insurance titanic. If you think employer coverage is worsening, try the individual market
    Emily Friedman
    Mod Healthc 33:23. 2003
  41. ncbi The Americans with Disabilities Act: an end to discrimination against HIV/AIDS patients or simply another loophole to bypass?
    Jill Alesch
    Drake University Law School, USA
    Drake Law Rev 52:523-51. 2004
  42. pmc Restrictions on provider access in health plans and socioeconomic status
    Partha Deb
    Department of Economics, Hunter College, City University of New York, 695 Park Avenue, HW 1524, New York, NY 10021, USA
    Health Serv Res 41:1821-46. 2006
    ..To model the socioeconomic determinants of restrictions on provider access and choices in health plans...
  43. doi Separate and unequal: self-segregation in health insurance
    Robert G Evans
    Centre for Health Services and Policy Research, UBC Campus, Vancouver, BC, Canada
    Med Care 46:1012-4. 2008
  44. ncbi Explaining racial and ethnic disparities in health care
    James B Kirby
    Center for Cost, Financing and Access Trends, Agency for Healthcare Research and Quality, Rockville, Maryland 20850, USA
    Med Care 44:I64-72. 2006
    ..We build on this previous research by incorporating additional factors such as attitudes about health care and neighborhood characteristics, as well as separately analyzing different Hispanic subgroups...
  45. ncbi A closer look at the managed care backlash
    Philip F Cooper
    Center for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality, Rockville, Maryland, USA
    Med Care 44:I4-11. 2006
    ..Much anecdotal evidence exists regarding the managed care backlash of the late 1990s, but limited empirical evidence is available...
  46. ncbi How health insurance inhibits trade in health care
    Aaditya Mattoo
    Development Research Group, World Bank in Washington, DC, USA
    Health Aff (Millwood) 25:358-68. 2006
    ..We propose that coverage should be neutral to provider location and that reimbursement should include travel costs...
  47. ncbi Risk selection in employer-sponsored managed care plans
    Monica Marchetta
    Changes in Health Care Financing and Organization, Washington, D C, USA
    Find Brief 8:1-5. 2005
  48. pmc Determinants of health insurance ownership among South African women
    Joses M Kirigia
    World Health Organization, Regional Office for Africa, Brazzaville, Congo
    BMC Health Serv Res 5:17. 2005
    ..The objective of this study was to examine the relationship between health insurance ownership and the demographic, economic and educational characteristics of South African women...
  49. pmc The effect of benefits, premiums, and health risk on health plan choice in the Medicare program
    Adam Atherly
    Department of Health Policy and Management, Emory University, Atlanta, GA 30322, USA
    Health Serv Res 39:847-64. 2004
    ..To estimate the effect of Medicare+Choice (M+C) plan premiums and benefits and individual beneficiary characteristics on the probability of enrollment in a Medicare+Choice plan...
  50. pmc Early experience with employee choice of consumer-directed health plans and satisfaction with enrollment
    Jinnet Briggs Fowles
    Park Nicollet Institute, 3800 Park Nicollet Boulevard, Minneapolis, MN 55416, USA
    Health Serv Res 39:1141-58. 2004
    ..To assess the initial impact of offering consumer-defined health plan (CDHP) options on employees...
  51. ncbi Effect of premium, copayments, and health status on the choice of health plans
    James M Naessens
    Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota 55902, USA
    Med Care 46:1033-40. 2008
    ..Explore effects of comorbidity and prior health care utilization on choice of employee health plans with different levels of cost sharing...
  52. ncbi Genetic discrimination in a time of false hopes
    John V Jacobi
    Health Law and Policy Program, Seton Hall Law School, USA
    Fla State Univ Law Rev 30:363-99. 2003
  53. ncbi Evaluating the effect of regulatory prohibitions against risk selection by health status on supplemental insurance ownership in Israel
    Revital Gross
    Health Policy Research Unit, JDC Brookdale Institute, P O Box 13087, Jerusalem 91130, Israel and School of Social Work, Bar Ilan University, Ramat Gan Israel
    Soc Sci Med 58:1609-22. 2004
    ....
  54. ncbi A comparison of single- and multi-payer health insurance systems and options for reform
    P Hussey
    Health Policy and Management, John Hopkins University, 624 N Broadway, Baltimore, MD 21205, USA
    Health Policy 66:215-28. 2003
    ..These reforms have been implemented with some success in several countries but face several important challenges...
  55. ncbi Service-level selection by HMOs in Medicare
    Zhun Cao
    Center for Multicultural Mental Health Research, Cambridge Health Alliance, 120 Beacon Street, 4th Floor, Somerville, MA 02143, USA
    J Health Econ 22:915-31. 2003
    ..We find evidence indicating that there exists significant service-level selection by HMOs...
  56. pmc Estimating the effects of prescription drug coverage for Medicare beneficiaries
    Dennis G Shea
    Department of Health Policy and Administration, The Pennsylvania State University, University Park, PA, USA
    Health Serv Res 42:933-49. 2007
    ..To identify the effect of insurance coverage on prescription utilization by Medicare beneficiaries...
  57. ncbi Enrollee mix, treatment intensity, and cost in competing indemnity and HMO plans
    Daniel Altman
    The New York Times, New York, NY, USA
    J Health Econ 22:23-45. 2003
    ..Contrary to conventional wisdom, indemnity plans do not have greater treatment intensity...
  58. pmc The role of perspective
    Harold S Luft
    Health Serv Res 37:245-50. 2002
  59. ncbi Outpatient encounter data for risk adjustment--a view from Europe: comments on Welch
    Peter C Smith
    Centre for Health Economics, University of York, York, United Kingdom
    J Ambul Care Manage 25:23-5. 2002
    ..The commentary concludes that, although risk adjustment research of this type is important, the most fundamental requirement is to develop a more active purchasing function on the part of insurers...
  60. ncbi Community rating in health insurance and different benefit packages
    Mathias Kifmann
    Universitat Konstanz, Germany
    J Health Econ 21:719-37. 2002
    ..However, high risk types can be made better off if CRIs must offer the additional benefit or if community rating health insurers offering the additional benefit are subsidized while those selling only the basic benefit are taxed...
  61. ncbi Cost-minimizing risk adjustment
    Yujing Shen
    Center for Health Quality, Outcomes and Economic Research, Boston University School of Public Health, Bedford, MA 01730, USA
    J Health Econ 21:515-30. 2002
    ..Estimations using privately-insured data suggest that cost-minimizing risk adjusted premiums reduce total sponsor costs as much as 25.6% below conventional risk adjustment premiums...
  62. pmc Risk adjustment alternatives in paying for behavioral health care under Medicaid
    S L Ettner
    UCLA Department of Medicine, Los Angeles, CA 90095-1736, USA
    Health Serv Res 36:793-811. 2001
    ..CONCLUSIONS: Current risk adjustment methodologies do not eliminate the financial incentives for integrated health plans and behavioral health care carve-out plans to avoid high-utilizing patients with psychiatric disorders...
  63. ncbi Alternative health insurance schemes: a welfare comparison
    Bodil O Hansen
    Institute of Economics, Copenhagen Business School, Frederiksberg, Denmark
    J Health Econ 21:739-56. 2002
    ..We further consider the situation where the compulsory scheme may be supplemented by voluntary competitive insurance; this situation turns out to be at least as good as either of the alternatives...
  64. ncbi Welfare effects of supplementary insurance: a comment
    Patricia M Danzon
    J Health Econ 21:923-6. 2002
  65. ncbi Genetic testing when there is a mix of compulsory and voluntary health insurance
    Michael Hoel
    Department of Economics, University of Oslo, Norway
    J Health Econ 21:253-70. 2002
    ..A reason may be that genetic insurance is not yet a political issue, and the advantage of shared genetic information is therefore not transparent...
  66. ncbi The prevalence of formal risk adjustment in health plan purchasing
    P S Keenan
    Harvard University, MA, USA
    Inquiry 38:245-59. 2001
    ..Ourfindings raise the question of why regulators have adopted formal risk adjustment, but private purchasers for the most part have not...
  67. ncbi Do welfare caseload declines make the Medicaid risk pool sicker?
    Bowen Garrett
    Health Policy Center of the Urban Institute, Washington, DC 20037, USA
    Inquiry 39:12-33. 2002
    ..We adjust utilization differences for insurance status and factors often used to adjust capitation rates. We conclude that declining welfare caseloads likely will result in a sicker and more expensive adult Medicaid risk pool...
  68. pmc Inside the sausage factory: improving estimates of the effects of health insurance expansion proposals
    Sherry Glied
    Department of Health Policy and Management, Mailman School of Public Health, Columbia University, 600 West 168 St, 6th Floor, New York, NY 10032, USA
    Milbank Q 80:603-35, iii. 2002
    ..The article also suggests ways of making models more transparent and proposes "reference case" guidelines for modelers so that consumers can compare modeling results...
  69. ncbi Consumer-driven health plans
    Anthony T Lo Sasso
    Health Aff (Millwood) 22:279-80; author reply 280. 2003
  70. ncbi Health insurance system promotes disparities
    Barbara Kivimae Krimgold
    Health Aff (Millwood) 22:279; author reply 280. 2003
  71. ncbi How profitable is risk selection? A comparison of four risk adjustment models
    Yujing Shen
    Department of Health Services, Boston University School of Public Health, USA
    Health Econ 11:165-74. 2002
    ..The magnitude of potential profit varies according to the risk adjustment model and the private information plans can employ to identify profitable enrollees...
  72. pmc Preference diversity and the breadth of employee health insurance options
    J R Moran
    Syracuse University, NY 13244-1020, USA
    Health Serv Res 36:911-34. 2001
    ..However, diseconomies of scale in the purchase and administration of health insurance appear to limit the extent to which small employers can accommodate diverse worker preferences...
  73. ncbi How and why the health insurance system will collapse
    Humphrey Taylor
    Harris Poll, Harris Interactive, New York City, USA
    Health Aff (Millwood) 21:195-7. 2002
    ..If unchecked by government intervention, these trends will lead to the collapse of employer-sponsored health insurance...
  74. ncbi Are HMO enrollees healthier than others? Results from the community tracking study
    Elizabeth Schaefer
    Center for Studying Health System Change, Washington, DC, USA
    Health Aff (Millwood) 21:249-58. 2002
    ..To help understand that result, we present evidence suggesting that other factors, including cost considerations, may be more important than health when people are deciding whether to enroll in an HMO...
  75. ncbi [Switching sickness funds and risk compensation mechanisms in the statutory health insurance system in Germany--empirical results from the cooperative health research in the region of Augsburg (KORA)]
    A Werner
    Kreiskrankenhaus Weilheim, Weilheim
    Gesundheitswesen 67:S158-66. 2005
    ..Therefore, the system of risk equalisation has to be developed towards measuring the risk volume borne by the sickness funds more precisely than hitherto...
  76. ncbi Medical privacy: from the 4th Amendment to HIPAA. Right to privacy vs. public health: showdown looms over patient genetic information
    E R Washburn
    El Dorado Pediatric Medical Group, Inc, Placerville, Calif, USA
    Physician Exec 27:22-9. 2001
    ..Learn the history of our privacy rights and regulations. And preview the privacy debates and dilemmas that await our digital society...
  77. ncbi A comprehensive snapshot of States' small group market reforms on insurer pricing & rating practices, 1999
    Sudha Xirasagar
    University of South Carolina, School of Public Health, Department of Health Services Policy and Management, Columbia, SC, USA
    J Health Soc Policy 19:61-81. 2004
    ..The variety in pricing and rating reforms illustrate the differences in the depth of reforms across states, and represent a far wider range of potential actuarial combinations than the sample of reforms documented in past literature...
  78. pmc The magnitude and nature of risk selection in employer-sponsored health plans
    Sean Nicholson
    Cornell University, Ithaca, NY 14853, USA
    Health Serv Res 39:1817-38. 2004
    ..To determine whether health maintenance organizations (HMOs) attract enrollees who use relatively few medical resources and whether a simple risk-adjustment system could mitigate or eliminate the inefficiency associated with risk selection...
  79. ncbi Voluntary health insurance in the European Union: a critical assessment
    Elias Mossialos
    European Observatory on Health Care Systems, London School of Economics and Political Science, United Kingdom
    Int J Health Serv 32:19-88. 2002
    ..In a deregulated environment, it is questionable whether this method of funding health care will encourage a more efficient and equitable allocation of resources...
  80. ncbi Risk segmentation and equity in the Chilean mandatory health insurance system
    Claudio Sapelli
    Department of Economics, Pontificia Universidad Catholica de Chile, Casilla 76 Carreo 17, Santiago, Chile
    Soc Sci Med 58:259-65. 2004
    ....
  81. ncbi Storm clouds in Michigan. Blues spars with governor over regulation, reform
    Laura B Benko
    Mod Healthc 32:12. 2002
  82. ncbi Payment. System breakdown
    Richard Haugh
    Hosp Health Netw 78:22, 24. 2004
  83. ncbi Older age underwriting: frisky vs frail
    Amy K Bennett
    Prudential Financial, 13001 County Road 10, Plymouth, MN 55442, USA
    J Insur Med 36:74-83. 2004
    ..Key features of frailty are social isolation, dependency in managing life activities and self-care, cognitive decline, shrinking of bone and muscle mass, and slow weight loss...
  84. ncbi The individual market: a delicate balance
    Scott Serota
    BlueCross BlueShield Association, Chicago, USA
    Health Aff (Millwood) . 2002
    ..Small miscalculations in any of these areas can quickly result in spiraling premiums and plummeting coverage rates...
  85. ncbi Dynamic process of adverse selection: evidence from a subsidized community-based health insurance in rural China
    Licheng Zhang
    The New School, Milano School for Management and Public Policy, New York, NY, USA
    Soc Sci Med 67:1173-82. 2008
    ..In addition, inequity of enrollment still exists under the current premium subsidy policy. Based on the findings, relevant policy implications are put forward to further improve the CHI scheme...
  86. ncbi Threats to your genetic privacy
    Bernadine Healy
    US News World Rep 143:86. 2007
  87. ncbi Voluntary disenrollment from Medicare advantage plans: valuable signals of market performance
    Lee R Mobley
    Research Triangle International, Research Triangle Park, NC 27709, USA
    Am J Manag Care 13:677-84. 2007
    ..To examine 2000-2005 trends in the reasons Medicare beneficiaries gave for disenrolling from their Medicare Advantage (MA) plans...
  88. ncbi Pricing implications of trends in population mortality and underwriting effectiveness
    Robert J Pokorski
    Gen Re LifeHealth Financial Centre, P O Box 300, 695 East Main Street, Stamford, CT 06904 0300, USA
    J Insur Med 36:54-9. 2004
    ..Factors that may increase or decrease the future effectiveness of underwriting are reviewed...
  89. ncbi Heart of the uninsured
    Arthur Garson
    School of Medicine, University of Virginia, Charlottesville, Virginia, USA
    Health Aff (Millwood) 26:227-31. 2007
  90. pmc Insurance problems among inflammatory bowel disease patients: results of a Dutch population based study
    M G V M Russel
    Department of Gastroenterology, University Hospital Maastricht, Maastricht, The Netherlands
    Gut 52:358-62. 2003
    ..In this study our aim was to document and compare the incidence of difficulties in application for life and medical insurance in a population based cohort of IBD patients and matched population controls...
  91. ncbi An analysis of the proposal for population based screening for hereditary hemochromatosis in Massachusetts
    J M LeGraw
    Boston University School of Public Health, USA
    J Biolaw Bus 4:51-8. 2001
    ....
  92. ncbi Genetic discrimination in health insurance--comprehensive legal solutions for a (not so) special problem?
    Robert F Rich
    University of Illinois, USA
    Indiana Health Law Rev 2:1-47. 2005
  93. ncbi Evaluating Medicaid HMOs when encounter data are missing: case of developmentally delayed children
    Farrokh Alemi
    Health System Management Program, College of Nursing and Health Sciences, George Mason University, Fairfax, Virginia, 4400 University Drive, Fairfax, VA 22030 4444, USA
    Health Care Manag Sci 6:37-42. 2003
    ..Data also showed that over 12 months, severity of FFS patients declined. Therefore, we inferred that the HMO was attracting sicker patients. The HMO was paid less than FFS plan, despite the fact that it attracted sicker patients...
  94. ncbi Victims of genetic discrimination speak up
    Peter Aldhous
    New Sci 188:7. 2005
  95. ncbi Health care policy evaluation using longitudinal insurance claims data: an application of the panel Tobit estimator
    P V Grootendorst
    Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
    Health Econ 6:365-82. 1997
    ..Little evidence of transitory effects to insurance coverage was found. Finally, the extension of insurance has made only a minor contribution to growth in seniors' drug use, relative to secular growth in drug use over time...
  96. ncbi Risk selection and risk adjustment: improving insurance in the individual and small group markets
    Katherine Baicker
    Department of Health Policy and Management, Harvard School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA
    Inquiry 46:215-28. 2009
    ..Reforms intended to increase insurance coverage and the value of care delivered will be much more effective if implemented in conjunction with policies that address these fundamental selection issues...
  97. ncbi The interaction of partial public insurance programs and residual private insurance markets: evidence from the US Medicare program
    Amy Finkelstein
    Harvard University and National Bureau of Economic Research, 1050 Massachusetts Ave, 3rd Floor, Cambridge, MA 02138, USA
    J Health Econ 23:1-24. 2004
    ..Medicare is, however, associated with a shift in the source of prescription drug coverage, from employer-provided coverage to Medicare HMOs...
  98. ncbi Complementary health insurance in France. Who pays? Why? Who will suffer from public disengagement?
    Bérengère Saliba
    ORS PACA, INSERM UMR 379 and CNRS UMR 6579, South Eastern France Regional Center for Disease Control, 23 rue Stanislas Torrents, 13006 Marseille, France
    Health Policy 81:166-82. 2007
    ..These results have broad implications for numerous national systems of social protection seeking a new mix between private and public insurance...
  99. pmc The moral foundations of health insurance
    J P Ruger
    Yale University School of Medicine, Department of Epidemiology and Public Health, 60 College Street, New Haven, CT 06525, USA
    QJM 100:53-7. 2007
  100. pmc Can decision biases improve insurance outcomes? An experiment on status quo bias in health insurance choice
    Miriam Krieger
    Fakultät für Wirtschaftswissenschaften, Universitat Duisburg Essen, Schützenbahn 70, Essen, Germany
    Int J Environ Res Public Health 10:2560-77. 2013
    ..Our results have implications for health care policy, for example suggesting that the use of non-binding defaults in health insurance can facilitate the spread of co-insurance policies and thereby help contain health care expenditure...
  101. ncbi Solidarity, genetic discrimination, and insurance: a defense of weak genetic exceptionalism
    Veikko Launis
    Department of Philosophy, University of Turku, Finland
    Soc Theory Pract 29:87-111. 2003

Research Grants28

  1. Treatment Patterns, Expenditures and Outcomes in MBHOs
    Susan Ettner; Fiscal Year: 2005
    ..e., how psychotherapy visits are associated with outcomes and expenditures. Selection models will be used to estimate this relationship for patients with and without drug use. ..
  2. Impact of the Medicare Part D Benzodiazepine Exclusion on Managed Care Patients
    Susan Ettner; Fiscal Year: 2008
    ..Our findings will inform the ongoing debate over amending Part D legislation to include BZD coverage by providing objective data to guide policymakers on the likely costs and benefits. [unreadable] [unreadable] [unreadable]..
  3. Costs of Preventing Alcohol Problems in Older Adults
    Susan Ettner; Fiscal Year: 2007
    ..abstract_text> ..
  4. Reimbursement Policy and Cancer Chemotherapy
    Joseph Newhouse; Fiscal Year: 2009
    ..Understanding its impact on chemotherapy treatment patterns has important implications not only for Medicare spending but also for the welfare of beneficiaries with cancer. ..
  5. Prescription Drug Cost-sharing: Affordability/Safety
    John Hsu; Fiscal Year: 2005
    ..This study will be the first to address these issues within a broad sample of Medicare beneficiaries. ..
  6. MH AND ADVERSE SELECTION IN MANAGED CARE
    Thomas McGuire; Fiscal Year: 2001
    ..Understanding how adverse selection works in managed care and what can be done about it should be a very high priority for research. ..
  7. Safety And Financial Ramifications of ED Copayments
    John Hsu; Fiscal Year: 2002
    ..abstract_text> ..
  8. Access to HIV-Related and Other Health Services for Rural-to-Urban Migrants
    Yogesh Rajkotia; Fiscal Year: 2008
    ..The results of this research should be instrumental in the development of theory-driven, empirically informed intervention strategies targeted to high-risk rural-to-urban migrants. ..
  9. Economic Evaluation of Addiction Services
    JENNIFER RUGER; Fiscal Year: 2007
    ..unreadable] [unreadable] [unreadable] [unreadable]..
  10. MODELING TREATMENT USE & EFFECTIVENESS IN MENTAL ILLNESS
    Sharon Lise Normand; Fiscal Year: 2007
    ..The methodological advances from this research will enable researchers, policy makers, and methodologists to better characterize factors impacting technology innovation/exnovation and to expand the inferences for usual care. ..
  11. NETWORK EFFECTS IN MENTAL HEALTH MANAGED CARE
    Thomas McGuire; Fiscal Year: 2002
    ..4) Test the behavior of the managed care plans against the predictions of the optimal network theory. ..
  12. The Spillover Effects of Health Insurance Coverage and Generosity
    Katherine Baicker; Fiscal Year: 2008
    ..unreadable] [unreadable] [unreadable]..
  13. Medicare Study of Cost-sharing Ramifications and Prescription Drug Benefits
    John Hsu; Fiscal Year: 2009
    ..This study will be the first to examine the clinical and economic effects of new Medicare Part D plans, using comprehensive automated data from before and after the introduction of Part D, for a well- defined population. ..
  14. Mental Health Spending and Quality of Care
    Thomas G McGuire; Fiscal Year: 2010
    ..We expand methods of the science of variations and apply them to mental health care using data from the Medicaid program. ..
  15. ANALYSIS OF MULTIPLE INFORMANT DATA IN PSYCHIATRY
    SHARON LISE TERESA NORMAND; Fiscal Year: 2010
    ..These novel and innovative methods will improve the assessment of treatment effects and will contribute to improving the health of the population. ..
  16. Impact of Health Information Technology on Clinical Care
    John Hsu; Fiscal Year: 2006
    ..In short, this natural experiment provides an ideal setting to understand the value of HIT in community-based, ambulatory care. [unreadable] [unreadable] [unreadable]..
  17. Telemedicine-Based Collaborative Care to Reduce Rural Health Disparities
    John C Fortney; Fiscal Year: 2010
    ..This population is at high risk for experiencing health disparities and thus, interventions targeting this population have the potential to have a major impact. ..
  18. PRICE INDEXES OF MENTAL HEALTH TREATMENT
    Richard Frank; Fiscal Year: 2002
    ..To assess outcomes we will use clinical literature along with three expert panels of clinician-researchers to rate expected outcomes for specific combinations of consumers and treatments. ..
  19. Industry-Sponsored Research Contracts:An Empirical Study
    Michelle Mello; Fiscal Year: 2002
    ..The data will be analyzed descriptively and with chi-squared tests and regression analysis. ..
  20. Cultural Model of Prevention in African-American Women
    Katrina Armstrong; Fiscal Year: 2004
    ..This understanding may lay the groundwork for improved understanding and trust between biomedical practitioners and African American patients. ..
  21. Industry-Sponsored Research Contracts:..Phase II
    Michelle Mello; Fiscal Year: 2004
    ..abstract_text> ..
  22. Economics of Racial & Ethnic Disparities in MH Services
    Thomas McGuire; Fiscal Year: 2005
    ..Test for evidence that patient reaction to provider discrimination leads to lower compliance rates and worse outcomes for these minorities. ..
  23. Race,Treatment and Endometrial Cancer Survival
    Katrina Armstrong; Fiscal Year: 2005
    ..In addition, within each category, we will investigate differences related to primary surgery and adjuvant radiation therapy. ..
  24. Distrust, Race/Ethnicity, and Predictive Genetic Testing
    Katrina Armstrong; Fiscal Year: 2005
    ....
  25. Economic Impacts of New Drugs
    Sharon Lise Normand; Fiscal Year: 2006
    ..Finally, we will examine the proposition that offsets occur differentially across racial and ethnic groups, for high utilizers and according to the organization of insurance arrangements. [unreadable] [unreadable]..
  26. Impact of Poor Health & AIDS on Small Businesses in SA
    Mark Pauly; Fiscal Year: 2003
    ..They will be useful for predicting the effect of changes in health on economic activity in this sector, and for allocating resources for disease prevention and treatment. ..
  27. HMO Selection Incentives and Underprovision of MH Care
    Zhun Cao; Fiscal Year: 2006
    ..abstract_text> ..
  28. Spatial Impact Factors and Mammography Screening
    Lee Mobley; Fiscal Year: 2006
    ..This work will demonstrate the feasibility of conducting a broader study encompassing more than twice as many counties of the United States (with additions covered by the expanded SEER database). ..