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Insurer Size and Negotiated Hospital Prices: Insights From the Affordable Care Act in Arkansas. 保险公司规模和协商医院价格：来自阿肯色州平价医疗法案的见解。
IF 2.4 3区 医学
Health economics Pub Date : 2025-08-01 DOI: 10.1002/hec.70022
Jee-Hun Choi
{"title":"Insurer Size and Negotiated Hospital Prices: Insights From the Affordable Care Act in Arkansas.","authors":"Jee-Hun Choi","doi":"10.1002/hec.70022","DOIUrl":"https://doi.org/10.1002/hec.70022","url":null,"abstract":"<p><p>This paper examines the role of insurer size in price negotiations between commercial health insurers and hospitals in the United States. The empirical analysis focuses on a dominant insurer in the Arkansas individual health insurance market that experienced a size increase due to a policy change. Under the Affordable Care Act (ACA), Arkansas expanded its Medicaid program, but unlike other expansion states, it used individual plans-a private insurance option generally not designed for Medicaid-to provide coverage to newly insured beneficiaries. This unique policy nearly doubled the insurer's individual plan enrollment after the ACA was implemented. Admission-level regression analysis reveals that the insurer's hospital inpatient prices for individual plans decreased by 16.7% following the expansion. Consistent with the predictions from bargaining models, the findings suggest that the insurer's increased bargaining leverage due to its larger size is the primary mechanism behind the price reduction.</p>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluating LTC Policies Around the World: A Virtual Special Issue Promoted by the Gateway to Global Aging Data Project. 评估全球LTC政策：全球老龄化数据门户项目推动的虚拟特刊。
IF 2.4 3区 医学
Health economics Pub Date : 2025-07-31 DOI: 10.1002/hec.70023
Giacomo Pasini, David Knapp, Marco Angrisani, Sally C Stearns
{"title":"Evaluating LTC Policies Around the World: A Virtual Special Issue Promoted by the Gateway to Global Aging Data Project.","authors":"Giacomo Pasini, David Knapp, Marco Angrisani, Sally C Stearns","doi":"10.1002/hec.70023","DOIUrl":"https://doi.org/10.1002/hec.70023","url":null,"abstract":"<p><p>To promote the evaluation of existing long-term care (LTC) policies and the involvement of the scientific community in future LTC policymaking, the Gateway to Global Aging Data project organized a conference in November 2023. This LTC Policy Virtual Special Issue features eight papers from this conference that were invited to undergo further blind peer review prior to publication in Health Economics. This introduction to the LTC Policy Virtual Special Issue provides a summary of each article, briefly covering the research question, conceptualization of the problem, approach used, methodological challenges, key outcomes and findings, and implications for policy and future research.</p>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Effect of Information From Black Health Care Professionals on COVID Vaccination Take-Up. 来自黑人卫生保健专业人员的信息对COVID疫苗接种的影响
IF 2 3区 医学
Health economics Pub Date : 2025-07-24 DOI: 10.1002/hec.70020
Martin Abel, Tanya Byker, Jeffrey Carpenter
{"title":"The Effect of Information From Black Health Care Professionals on COVID Vaccination Take-Up.","authors":"Martin Abel, Tanya Byker, Jeffrey Carpenter","doi":"10.1002/hec.70020","DOIUrl":"https://doi.org/10.1002/hec.70020","url":null,"abstract":"<p><p>This study experimentally tests the impact of providing information about vaccine safety and efficacy delivered by Black health care professionals. We find that providing general information increases vaccination rates after 5 months by 8 percentage points (17%), driven by a 9.8 pp (24%) increase among white participants. Political affiliation emerges as a key moderator to explain this discordant effect. Across race, general information is more effective for politically moderate and conservative respondents, most of whom are white. Among this most vaccine-hesitant group, the information effectively addresses concerns about both side effects and unknown long-run effects due to the fast approval of the vaccine, increasing vaccination rates by 14 pp.</p>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Classifying the Integration of Healthcare Providers and Insurers. 医疗保健提供者和保险公司的整合分类。
IF 2 3区 医学
Health economics Pub Date : 2025-07-22 DOI: 10.1002/hec.70019
Xiaodan Liang, John Mullahy
{"title":"Classifying the Integration of Healthcare Providers and Insurers.","authors":"Xiaodan Liang, John Mullahy","doi":"10.1002/hec.70019","DOIUrl":"https://doi.org/10.1002/hec.70019","url":null,"abstract":"<p><p>The value-based payment reform prompted by the Affordable Care Act has stimulated vertical integrations of healthcare providers and insurers. The consequences of these integrations may vary significantly depending on the markets and entities involved. This article points out the limitations of familiar binary classifications for provider-insurer integrations in prior studies. To address these limitations, we propose a framework and taxonomy that include four key aspects for examining variations in provider-insurer integrations. The first is from the care delivery perspective; it sheds light on levels of care services owned by an integrated system and their variation across regions within the system. The second is from the insurance markets' perspective; it pertains to insurance markets in which an integrated system competes. The third is from the organizational perspective; it points out that whether the insurer or the provider is dominant in an integrated system may affect the system's priorities-care delivery reform or cost containment. The last highlights the dynamics of integrated systems that can involve the other three. We offer these insights and their possible applications hoping to sharpen discussion and research on provider-insurer integrations, and to assist antitrust agencies in evaluating relevant legal cases under the 2023 Merger Guidelines.</p>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hidden Costs of Ban the Box Laws: Unraveling the Effects on Drug-Related Deaths. 禁盒法的隐性成本：揭开毒品相关死亡的影响。
IF 2 3区 医学
Health economics Pub Date : 2025-07-19 DOI: 10.1002/hec.70018
Oleksandra Cheipesh
{"title":"Hidden Costs of Ban the Box Laws: Unraveling the Effects on Drug-Related Deaths.","authors":"Oleksandra Cheipesh","doi":"10.1002/hec.70018","DOIUrl":"https://doi.org/10.1002/hec.70018","url":null,"abstract":"<p><p>Ban the Box (BTB) laws delay criminal background checks until the later stages of the hiring process. This study provides new evidence that BTB laws that apply to both private and public employers have negative spillover effects beyond labor market outcomes. Drawing on data from the National Vital Statistics System (NVSS), I investigate the impact of BTB laws on drug-related mortality. Two years after adoption, BTB laws are associated with more than a 35 percent increase in drug-related mortality among Black and Hispanic men. The main mechanism appears to be diminished labor opportunities. BTB adoption reduces wages and the probability of employment among Black and Hispanic men.</p>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Behavioral Adaptation to Improved Environmental Quality: Evidence From a Sanitation Intervention. 改善环境质量的行为适应：来自卫生干预的证据。
IF 2 3区 医学
Health economics Pub Date : 2025-07-19 DOI: 10.1002/hec.70016
Lisa Cameron, An Huang, Paulo Santos, Milan Thomas
{"title":"Behavioral Adaptation to Improved Environmental Quality: Evidence From a Sanitation Intervention.","authors":"Lisa Cameron, An Huang, Paulo Santos, Milan Thomas","doi":"10.1002/hec.70016","DOIUrl":"https://doi.org/10.1002/hec.70016","url":null,"abstract":"<p><p>This paper investigates behavioral adaptation to local improvements in environmental quality. Using exogenous variation in village sanitation coverage generated by the randomised allocation of financial incentives to latrine construction in Lao PDR, we find that the generalized adoption of improved sanitation led to significant reductions in the practice of boiling water for drinking. Our analysis suggests that this change is likely a behavioral response to a reduction in the health benefits associated with treating water, which decline and eventually become negligible as local adoption of improved sanitation increases. Estimates of the value of time savings associated with the reduction in water boiling suggest that this adaptation is an additional important benefit of sanitation investments, most of which likely accrues to girls and women.</p>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Digitalization of Access to Primary Care: Is There an Equity-Efficiency Trade-Off? 初级保健的数字化：是否存在公平-效率的权衡？
IF 2 3区 医学
Health economics Pub Date : 2025-07-17 DOI: 10.1002/hec.70014
Daniela Rodrigues, Noemi Kreif, Ara Darzi, Mauricio Barahona, Erik Mayer
{"title":"Digitalization of Access to Primary Care: Is There an Equity-Efficiency Trade-Off?","authors":"Daniela Rodrigues, Noemi Kreif, Ara Darzi, Mauricio Barahona, Erik Mayer","doi":"10.1002/hec.70014","DOIUrl":"https://doi.org/10.1002/hec.70014","url":null,"abstract":"<p><p>In the English National Health Service, most patients can use an online platform to send a written request to the practice, in addition to calling or visiting the practice in person. However, there are concerns that the availability of an online access route to primary care can adversely impact healthcare provision for older or lower socioeconomic groups. To examine those concerns, we explore the differential timing of online platforms' implementation between 2019 and 2020 across 289 practices covering over 2.5 million patients in North West London. We find no evidence of an impact of the online access route on age and socioeconomic-related inequity in synchronous interactions in primary care, but observe an increase in all interactions in this setting and in some cases, a small reduction (worst case, no changes) in unplanned hospital care. These findings suggest that having an online access route to primary care can improve the provision of healthcare services, at no detriment to patients from older and lower socioeconomic groups.</p>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Walkability and Mental Health Resiliency During the COVID-19 Pandemic. COVID-19大流行期间的步行性和心理健康弹性。
IF 2 3区 医学
Health economics Pub Date : 2025-07-17 DOI: 10.1002/hec.70013
Karen Smith Conway, Andrea K Menclova
{"title":"Walkability and Mental Health Resiliency During the COVID-19 Pandemic.","authors":"Karen Smith Conway, Andrea K Menclova","doi":"10.1002/hec.70013","DOIUrl":"https://doi.org/10.1002/hec.70013","url":null,"abstract":"<p><p>This study investigates if local walkability helped mitigate the well-documented mental health impacts of the COVID-19 pandemic. Walkability may improve mental health by facilitating walking (which our data suggest occurred during the pandemic), as well as through other avenues such as time spent outdoors and improved social ties. However, estimating the causal effects of walkability is challenged by its lack of exogenous time variation. Our empirical approach uses the pandemic as a geographically-variable and arguably-random shock to mental health which, when combined with Census tract measures of walkability and mental health, sheds light on the possible impact of local walkability on mental health resiliency. Focusing on within-county, over-time variation in mental health and controlling for a wide set of local factors, results suggest that those living in a more walkable community experienced smaller declines in mental health. The magnitudes are reasonable; increasing walkability by one standard deviation is associated with a 4 percent reduction in the average pandemic-related deterioration in mental health. These findings are robust to many sensitivity checks and falsification tests. Although the pandemic is the random shock studied here, this research has implications for the potential role of walkability in diminishing the mental health effects of other stressors.</p>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Impact of Child Disability on Parental Outcomes: Evidence From Sweden. 儿童残疾对父母结局的影响：来自瑞典的证据。
IF 2 3区 医学
Health economics Pub Date : 2025-07-14 DOI: 10.1002/hec.70017
Derek Asuman, Ulf-G Gerdtham, Ann I Alriksson-Schmidt, Martin Nordin, Johan Jarl
{"title":"The Impact of Child Disability on Parental Outcomes: Evidence From Sweden.","authors":"Derek Asuman, Ulf-G Gerdtham, Ann I Alriksson-Schmidt, Martin Nordin, Johan Jarl","doi":"10.1002/hec.70017","DOIUrl":"https://doi.org/10.1002/hec.70017","url":null,"abstract":"<p><p>Parents of children with disabilities may face higher labor-market penalties given the extra care and support required. Using Swedish administrative data, we focus on first-born children with Cerebral Palsy (CP) to estimate impacts on parental labor-market outcomes. We apply an event study approach to identify effects up to 10 years after the birth of the child. Our results show that employment and earnings of mothers decrease in the short run and increase in the long run whereas for fathers, a marginal decrease is observed in the short run. The effects differ by severity of the disability, with mothers of children with severe impairments driving the increases in the long run, whilst mothers of children with mild impairments appear to experience a penalty. Further, transfers and benefits from the Swedish social insurance system compensate parents for some of the potential costs associated with caring for a child with CP.</p>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Anti-Bullying Laws and Weight-Based Disparities in Suicidality. 反欺凌法律和体重在自杀方面的差异。
IF 2 3区 医学
Health economics Pub Date : 2025-07-13 DOI: 10.1002/hec.70015
Brandyn F Churchill, Bijesh Gyawali, Joseph J Sabia
{"title":"Anti-Bullying Laws and Weight-Based Disparities in Suicidality.","authors":"Brandyn F Churchill, Bijesh Gyawali, Joseph J Sabia","doi":"10.1002/hec.70015","DOIUrl":"https://doi.org/10.1002/hec.70015","url":null,"abstract":"<p><p>Appearance-based bullying is common among teenagers and may inflict substantial psychological harm on its victims. Overweight and obese students are both more likely to be bullied at school and more likely to engage in suicidal behaviors than their healthy-weight counterparts. This study is the first to explore how anti-bullying laws (ABLs) affect disparities in suicidality between overweight and obese U.S. high school students compared to their and healthy-weight counterparts. Using data from the National and State Youth Risk Behavior Surveys and a difference-in-differences approach, we find that ABL adoption is associated with a 6-19 percent reduction in suicidal behaviors among overweight or obese teens; estimates for healthy-weight teens are considerably smaller in magnitude and statistically insignificant. Weight-based disparities in suicidal behaviors are reduced most by ABLs among obese teenage girls. An exploration of mechanisms suggests that improvements in the quality of peer interactions in school-rather than ABL-induced changes in body weight (sample selection) or students' own-weight perception-generate disparate mental health gains for at-risk youth. We conclude that curbing targeted bullying based on appearance yields important health benefits.</p>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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