Data and code for: Hospital Network Competition and Adverse Selection: Evidence from the Massachusetts Health Insurance Exchange
Principal Investigator(s): View help for Principal Investigator(s) Mark Shepard, Harvard University: Kennedy School of Government
Version: View help for Version V1
| Name | File Type | Size | Last Modified |
|---|---|---|---|
| AppendixFigures | 09/07/2021 12:48:PM | ||
| Figures | 09/07/2021 12:48:PM | ||
| FormattedAppendixTables | 09/07/2021 12:48:PM | ||
| FormattedTables | 09/07/2021 12:48:PM | ||
| PublicData | 09/07/2021 12:48:PM | ||
| RawAppendixTables | 09/07/2021 12:49:PM | ||
| RawTables | 09/07/2021 12:49:PM | ||
| Scripts | 09/07/2021 12:49:PM | ||
|
|
text/plain | 15.7 KB | 09/07/2021 08:47:AM |
|
|
application/vnd.openxmlformats-officedocument.wordprocessingml.document | 27.9 KB | 11/06/2021 10:50:AM |
- Total of 11 records. Records per page
- « previous Page of 2
- next »
Project Citation:
Shepard, Mark. Data and code for: Hospital Network Competition and Adverse Selection: Evidence from the Massachusetts Health Insurance Exchange. Nashville, TN: American Economic Association [publisher], 2022. Ann Arbor, MI: Inter-university Consortium for Political and Social Research [distributor], 2022-01-20. https://doi.org/10.3886/E149501V1
Project Description
Summary:
View help for Summary
This is data and code for "Hospital Network Competition and Adverse Selection" to be published in the American Economic Review. Here is the paper's abstract:
Health insurers increasingly compete on their networks of medical providers. Using data from Massachusetts’ insurance exchange, I find substantial adverse selection against plans covering the most prestigious and expensive “star” hospitals. I highlight a theoretically distinct selection channel: consumers loyal to star hospitals incur high spending, conditional on their medical state, because they use these hospitals' expensive care. This implies heterogeneity in consumers' incremental costs of gaining access to star hospitals, posing a challenge for standard selection policies. Along with selection on unobserved sickness, I find this creates strong incentives to exclude star hospitals, even with risk adjustment in place.
Health insurers increasingly compete on their networks of medical providers. Using data from Massachusetts’ insurance exchange, I find substantial adverse selection against plans covering the most prestigious and expensive “star” hospitals. I highlight a theoretically distinct selection channel: consumers loyal to star hospitals incur high spending, conditional on their medical state, because they use these hospitals' expensive care. This implies heterogeneity in consumers' incremental costs of gaining access to star hospitals, posing a challenge for standard selection policies. Along with selection on unobserved sickness, I find this creates strong incentives to exclude star hospitals, even with risk adjustment in place.
Funding Sources:
View help for Funding Sources
Harvard University. Department of Economics;
United States Department of Health and Human Services. National Institutes of Health. National Institute on Aging (T32-AG000186);
Rumsfeld Foundation graduate fellowship;
National Science Foundation
Scope of Project
Subject Terms:
View help for Subject Terms
health insurance;
Adverse selection;
Hospital networks
JEL Classification:
View help for JEL Classification
I11 Analysis of Health Care Markets
I13 Health Insurance, Public and Private
I18 Health: Government Policy; Regulation; Public Health
L13 Oligopoly and Other Imperfect Markets
I11 Analysis of Health Care Markets
I13 Health Insurance, Public and Private
I18 Health: Government Policy; Regulation; Public Health
L13 Oligopoly and Other Imperfect Markets
Geographic Coverage:
View help for Geographic Coverage
Massachusetts, United States
Time Period(s):
View help for Time Period(s)
11/1/2006 – 12/31/2013
Collection Date(s):
View help for Collection Date(s)
1/2014 – 2/2014
Universe:
View help for Universe
Enrollees in Massachusetts' subsidized health insurance exchange (Commonwealth Care)
Data Type(s):
View help for Data Type(s)
program source code
Collection Notes:
View help for Collection Notes
See README.docx for additional information on the data.
Methodology
Data Source:
View help for Data Source
1. Administrative records from the Massachusetts Health Connector
2. Administrative health insurance claims from insurers participating in the Commonwealth Care market
3. Hospital characteristics from the American Hospital Association
4. Driving distance data between hospitals and Massachusetts zip codes from Google maps
2. Administrative health insurance claims from insurers participating in the Commonwealth Care market
3. Hospital characteristics from the American Hospital Association
4. Driving distance data between hospitals and Massachusetts zip codes from Google maps
Unit(s) of Observation:
View help for Unit(s) of Observation
Individual enrollee x month,
Health care claim
Related Publications
Published Versions
Report a Problem
Found a serious problem with the data, such as disclosure risk or copyrighted content? Let us know.
This material is distributed exactly as it arrived from the data depositor. ICPSR has not checked or processed this material. Users should consult the investigator(s) if further information is desired.