相关论文: Empirical Characteristics of Affordable Care Act R…
The Affordable Care Act (ACA) includes a permanent revenue transfer methodology which provides financial incentives to health insurance plans that have higher than average actuarial risk. In this paper, we derive some statistical…
The Affordable Care Act introduced a revenue transfer formula that requires insurance plans with generally healthier enrollees to pay funds into a revenue transfer pool for to reimburse plans with generally less healthy enrollees. For a…
The distribution of health care payments to insurance plans has substantial consequences for social policy. Risk adjustment formulas predict spending in health insurance markets in order to provide fair benefits and health care coverage for…
Risk adjustment in health care aims to redistribute payments to insurers based on costs. However, risk adjustment formulas are known to underestimate costs for some groups of patients. This undercompensation makes these groups unprofitable…
Healthcare information systems deal with a large amount of Personally Identifiable Information related to patients like dates of birth and social security numbers, patients health information and history, and financial information like…
In this study an exploration of insurance risk transfer is undertaken for the cyber insurance industry in the United States of America, based on the leading industry dataset of cyber events provided by Advisen. We seek to address two core…
Insurers underwrite risks: they calculate risks and decide on the insurance price. Insurers seem captivated by two trends enabled by Artificial Intelligence (AI). First, insurers could use AI for analysing more and new types of data to…
No one doubts the utility of insurance for its ability to spread risk or streamline claims management; much debated is when and how insurance uptake can improve welfare by reducing harm, despite moral hazard. Proponents and dissenters of…
In 2014 the Patient Protection and Affordable Care Act (ACA) introduced the expansion of Medicaid where states can opt to expand the eligibility for those in need of free health insurance. In this paper, we attempt to assess the…
Improper health insurance payments resulting from fraud and upcoding result in tens of billions of dollars in excess health care costs annually in the United States, motivating machine learning researchers to build anomaly detection models…
Efficient risk transfer is an important condition for ensuring the sustainability of a market according to the established economics literature. In an inefficient market, significant financial imbalances may develop and potentially…
Patients whose transfer to the Intensive Care Unit (ICU) is unplanned are prone to higher mortality rates than those who were admitted directly to the ICU. Recent advances in machine learning to predict patient deterioration have introduced…
We provide sufficient conditions for semi-nonparametric point identification of a mixture model of decision making under risk, when agents make choices in multiple lines of insurance coverage (contexts) by purchasing a bundle. As a first…
The frequent occurrence of natural disasters has posed significant challenges to society, necessitating the urgent development of effective risk management strategies. From the early informal community-based risk sharing mechanisms to…
OBJECTIVE: To propose time-to-event estimators that help evaluate incident diagnostic coding and possible upcoding in Medicare as well as introduce an open-source software package that enables more reproducible methods development relevant…
Adjustments to public health policy are common. This paper investigates the impact of COVID-19 policy ambiguity on specific groups' insurance consumption. The results show that sensitive groups' willingness to pay (WTP) for insurance is…
Under the ACA, the federal government paid a substantially larger share of medical costs of newly eligible Medicaid enrollees than previously eligible ones. States could save up to 100% of their per-enrollee costs by reclassifying original…
The demand for voluntary insurance against low-probability, high-impact risks is lower than expected. To assess the magnitude of the demand, we conduct a meta-analysis of contingent valuation studies using a dataset of experimentally…
Recent initiatives that overstate health insurance coverage for well-being conflict with the recognized antagonistic facts identified by the determinants of health that identify health care as an intermediate factor. By using a network of…
Risk perceptions are essential in cyber insurance contracts. With the recent surge of information, human risk perceptions are exposed to the influences from both beneficial knowledge and fake news. In this paper, we study the role of the…