Employer Incentives and Distortions in Health Insurance Design: Implications for Welfare and Costs
中文摘要
本文研究雇主在设计健康保险医疗服务提供者网络时的激励，以及观察到的保险供给是否反映了与员工相一致的偏好。我估计了一个供求模型，在该模型中，我将雇主的健康计划供给相对于医院和医生网络内生化。我发现，雇主通过赋予特定员工（特别是年长员工以及医疗服务提供者竞争较少地区的员工）的偏好高于普通员工家庭的偏好，从而“过度提供”了宽泛的网络。促使雇主在不同地理市场提供不同的医疗服务提供者网络，可以带来剩余的实质性增加，且仅产生极小的分配效应或选择效应。（JEL G22, G28, I13, J32, M52）
Abstract
This paper studies employer incentives in designing health insurance provider networks and whether observed offerings reflect preferences that are aligned with employees. I estimate a model of supply and demand where I endogenize employer health plan offerings with respect to hospital and physician networks. I find that employers “overprovide” broad networks by overweighting the preferences of certain employees, specifically older workers and those in regions with less provider competition, over the preferences of the average employee household. Shifting employers toward offering different provider networks in different geographic markets could yield substantial gains to surplus, with minimal distributional or selection effects. (JEL G22, G28, I13, J32, M52)