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The Evolution of Health Insurer Costs in Massachusetts, 2010–2012

Author

Listed:
  • Kate Ho

    (Columbia University
    NBER)

  • Ariel Pakes

    (Harvard University
    NBER)

  • Mark Shepard

    (Harvard University
    NBER)

Abstract

We analyze the evolution of health insurer costs in Massachusetts between 2010 and 2012, paying particular attention to changes in the composition of enrollees. This was a period in which Health Maintenance Organizations (HMOs) increasingly used physician cost control incentives but Preferred Provider Organizations (PPOs) did not. We show that cost growth and its components cannot be understood without accounting for (1) consumers’ switching between plans, and (2) differences in cost characteristics between new entrants and those leaving the market. New entrants are markedly less costly than those leaving (and their costs fall after their entering year), so cost growth of continuing enrollees in a plan is significantly higher than average per-member cost growth. Relatively high-cost HMO members switch to PPOs while low-cost PPO members switch to HMOs, so the impact of cost control incentives on HMO costs is likely different from their impact on market-wide insurer costs.

Suggested Citation

  • Kate Ho & Ariel Pakes & Mark Shepard, 2018. "The Evolution of Health Insurer Costs in Massachusetts, 2010–2012," Review of Industrial Organization, Springer;The Industrial Organization Society, vol. 53(1), pages 117-137, August.
    • Handle: RePEc:kap:revind:v:53:y:2018:i:1:d:10.1007_s11151-018-9623-2
    DOI: 10.1007/s11151-018-9623-2
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    References listed on IDEAS

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    1. Abe Dunn & Eli Liebman & Adam Hale Shapiro, 2016. "Decomposing Medical Care Expenditure Growth," NBER Chapters, in: Measuring and Modeling Health Care Costs, pages 81-111, National Bureau of Economic Research, Inc.
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    5. Benjamin R. Handel, 2013. "Adverse Selection and Inertia in Health Insurance Markets: When Nudging Hurts," American Economic Review, American Economic Association, vol. 103(7), pages 2643-2682, December.
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    Cited by:

    1. Christopher M. Snyder & Victor J. Tremblay, 2018. "Introduction to the Special Issue on “The Intersection Between Industrial Organization and Healthcare Economics”," Review of Industrial Organization, Springer;The Industrial Organization Society, vol. 53(1), pages 1-6, August.

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