International Journal of Health Care Finance and Economics This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Specialization and production cost efficiency: evidence from ambulatory surgery centers
AbstractIn the U.S. health care sector, the economic logic of specialization as an organizing principle has come under active debate in recent years. An understudied case is that of ambulatory surgery centers (ASCs), which recently have become the dominant provider of specific surgical procedures. While the majority of ASCs focus on a single specialty, a growing number are diversifying to offer a wide range of surgical services. We take a multiple output cost function approach to an empirical investigation that compares production economies in single specialty ASCs with those in multispecialty ASCs. We applied generalized ...
Source: International Journal of Health Care Finance and Economics - September 12, 2017 Category: Health Management Source Type: research

Taking the hassle out of wellness: Do peers and health matter?
AbstractDespite substantial financial incentives provided by the Affordable Care Act and employers, employee enrollment in wellness programs is low. This paper studies enrollment in a wellness program offered along an employer-provided health insurance plan. Two factors are considered in the choice of health plan with wellness: the effect of peer choices and family health on plan choice. Using exclusively obtained data of health insurance plan choice and utilization, this paper compares similar plans and focuses on a subsample of new employees. Result show that peers affect own choice of health insurance: a 10 percentage p...
Source: International Journal of Health Care Finance and Economics - August 31, 2017 Category: Health Management Source Type: research

Organizational learning-by-doing in liver transplantation
AbstractOrganizational learning-by-doing implies that production outcomes improve with experience. Prior empirical research documents the existence of organizational learning-by-doing, but provides little insight into why some firms learn while others do not. Among the 124 U.S. liver transplant centers that opened between 1987 and 2009, this paper shows evidence of organizational learning-by-doing, but only shortly after entry. Significant heterogeneity exists with learning only evident among those firms entering early in the sample period when liver transplantation was an experimental medical procedure. Firms that learn b...
Source: International Journal of Health Care Finance and Economics - August 30, 2017 Category: Health Management Source Type: research

Health expenditure and growth dynamics in the SADC region: evidence from non-stationary panel data with cross section dependence and unobserved heterogeneity
AbstractThis paper investigates the long run relationship between health care expenditure and economic growth, using panel data for 14 Southern African Development Community (SADC) member countries over the period 1995 –2012. The non-stationarity and cointegration properties between health expenditure per capita and GDP per capita were examined, controlling for cross section dependence and heterogeneity between countries. Our results suggest that health expenditure and GDP per capita are non-stationary and coint egrated. These findings seem to confirm the notion that health expenditure is non-discretionary—health is a ...
Source: International Journal of Health Care Finance and Economics - August 30, 2017 Category: Health Management Source Type: research

The short- and long-run effects of smoking cessation on alcohol consumption
AbstractThis paper examines the short- and long-term effects of quitting smoking on alcohol consumption using the Lung Health Study, a randomized smoking cessation program. The paper estimates the relationship between smoking and alcohol consumption using several self-reported and objective smoking measures, while also implementing a two-stage least squares estimation strategy that utilizes the randomized smoking cessation program assignment as an instrument for smoking. The analysis leads to three salient findings. First, self-reported and clinically verified smoking measures provide mixed evidence on the short-term impac...
Source: International Journal of Health Care Finance and Economics - August 7, 2017 Category: Health Management Source Type: research

Public expenditure and healthcare utilization: the case of reproductive health care in India
AbstractAn important reason for public intervention in health in developing countries is to address the issue of accessibility. However, numerous studies have found inconclusive evidence of the effect of public expenditure on health outcomes. Here, I revisit the debate by examining the effect of public expenditure on the use of health services, which is an important link between expenditure and outcomes. I use data from two recent waves of the National Family Health Survey of India to study the role of public expenditure on the use of healthcare services during pregnancy and childbirth. India has high state-level variation...
Source: International Journal of Health Care Finance and Economics - July 12, 2017 Category: Health Management Source Type: research

Smoking behaviour and health care costs coverage: a European cross-country comparison
AbstractThe empirical evidence about the effect of smoking on health care cost coverage is not consistent with the expectations based on the notion of adverse selection. This evidence is mostly based on correlational studies which cannot isolate the adverse selection effect from the moral hazard effect. Exploiting data from the Survey of Health, Aging, and Retirement in Europe, this study uses an instrumental variable strategy to identify the causal effect of daily smoking on perceived health care cost coverage of those at age 50 or above in 12 European countries. Daily smoking is instrumented by a variable indicating whet...
Source: International Journal of Health Care Finance and Economics - May 30, 2017 Category: Health Management Source Type: research

Endogenous versus exogenous generic reference pricing for pharmaceuticals
AbstractIn this paper we carry out a vertical differentiation duopoly model applied to pharmaceutical markets to analyze how endogenous and exogenous generic reference pricing influence competition between generic and branded drugs producers. Unlike the literature, we characterize for the exogenous case the equilibrium prices for all feasible relevant reference prices. Competition is enhanced after the introduction of a reference pricing system. We also compare both reference pricing systems on welfare grounds, assuming two different objective functions for health authorities: (i) standard social welfare and (ii) gross con...
Source: International Journal of Health Care Finance and Economics - May 15, 2017 Category: Health Management Source Type: research

Comparisons of hospital output in Canada: national and international perspectives
AbstractCurrent cost-based approach in measuring health care output does not allow decomposition of health care expenditure into price and output components. In this paper we propose an episode-based direction measurement method which closely resembles the concept of output in the system of national accounts. Using data from the Canadian Institute for Health Information, we calculate a quality unadjusted output index of the Canadian hospital sector for the periods 1996 –2005. The result shows that total output increases at an average annual growth rate of 1.49%. We expect that with the quality adjustment the actual rate ...
Source: International Journal of Health Care Finance and Economics - May 12, 2017 Category: Health Management Source Type: research

What drives insurer participation and premiums in the Federally-Facilitated Marketplace?
AbstractWe investigate determinants of market entry and premiums within the context of the Affordable Care Act ’s Marketplaces for individual insurance. Using Bresnahan and Reiss (1991) as the conceptual framework, we study how competition and firm heterogeneity relate to premiums in 36 states using Federally Facilitated or Supported Marketplaces in 2016. Our primary data source is the Qualified Health Plan Landscape File, augmented with market characteristics from the American Community Survey and Area Health Resource File as well as insurer-level information from federal Medical Loss Ratio annual reports. We first esti...
Source: International Journal of Health Care Finance and Economics - April 26, 2017 Category: Health Management Source Type: research

Long-term care provision, hospital bed blocking, and discharge destination for hip fracture and stroke patients
AbstractWe examine the relationship between long-term care supply (care home beds and prices) and (i) the probability of being discharged to a care home and (ii) length of stay in hospital for patients admitted to hospital for hip fracture or stroke. Using patient level data from all English hospitals and allowing for a rich set of demographic and clinical factors, we find no association between discharge destination and long-term care beds supply or prices. We do, however, find evidence of bed blocking: hospital length of stay for hip fracture patients discharged to a care home is shorter in areas with more long-term care...
Source: International Journal of Health Care Finance and Economics - February 27, 2017 Category: Health Management Source Type: research

The effects of public health insurance expansion on private health insurance in urban China
AbstractThe public social health insurance coverage has rapidly increased in China in the last decade. The rapid market development and high economic growth also present an immense opportunity for the private insurance market. This paper uses the China Health and Nutrition Survey panel data and the difference-in-difference method to identify the causal effects of public health insurance expansion on private health insurance development in the case of expansion of the China Urban Residential Basic Medical Insurance (URBMI) program. The paper finds private health insurance enrollment is not affected by the introduction and e...
Source: International Journal of Health Care Finance and Economics - February 7, 2017 Category: Health Management Source Type: research

The impact of health insurance expansion on physician treatment choice: Medicare Part D and physician prescribing
AbstractWe test the effect of the introduction of Medicare Part D on physician prescribing behavior by using data on physician visits from the National Ambulatory Medical Care Survey (NAMCS) 2002 –2004 and 2006–2009 for patients aged 60–69. We use regression discontinuity designs to estimate the effect of part D around the age of 65 before and after 2006 and then compare the discrete jump in outcomes at age 65 before and after Part D. We find a 32% increase in the number of prescriptio n drugs prescribed or continued per visit and a 46% increase in the number of generic drugs prescribed or continued for the elderly a...
Source: International Journal of Health Care Finance and Economics - February 5, 2017 Category: Health Management Source Type: research

The impact of firms ’ adjustments on the indirect cost of illness
We present a model allowing the estimation of IC with such adjustment s. We show that the risk of illness does not change the general shape and properties of the (expected) marginal productivity function. We apply our model to several illustrative examples and show that firm’s adjustments impact IC in an ambiguous way, depending on detailed company/market characteri stics: in some cases the company reduces the employment (further increasing IC), in another—the opposite happens. Contrary to previous findings, teamwork and shortfall penalties may reduce IC in some settings. Our analysis highlights that IC should be split...
Source: International Journal of Health Care Finance and Economics - February 1, 2017 Category: Health Management Source Type: research

The availability and marginal costs of dependent employer-sponsored health insurance
In this study, we examine differences by firm size in the availability of dependent coverage and the incremental cost of such coverage. We use data from the Medical Expenditure Panel Survey - Insurance Component (MEPS-IC) to show that among employees eligible for single coverage, dependent coverage was almost always available for employees in large firms (100 or more employees) but not in smaller firms, particularly those with fewer than 10 employees. In addition, when dependent coverage was available, eligible employees in smaller firms were more likely than employees in large firms to face two situations that represented...
Source: International Journal of Health Care Finance and Economics - January 20, 2017 Category: Health Management Source Type: research