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Timothy James Layton

Citations

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Working papers

  1. Timothy Layton & Eran Politzer, 2024. "The Dynamic Fiscal Costs of Outsourcing Health Insurance - Evidence from Medicaid," NBER Working Papers 33302, National Bureau of Economic Research, Inc.

    Cited by:

    1. Lee, Ajin & Rossin-Slater, Maya & Staiger, Becky & Su, Amanda, 2026. "The Impacts of Medicaid's Managed Long-Term Services and Supports on Health Outcomes in Medicare," IZA Discussion Papers 18628, IZA Network @ LISER.
    2. Politzer, Eran, 2025. "A change of plans: Switching costs in the procurement of health insurance," Journal of Health Economics, Elsevier, vol. 102(C).

  2. Keith Marzilli Ericson & Timothy J. Layton & Adrianna McIntyre & Adam Sacarny, 2023. "Reducing Administrative Barriers Increases Take-up of Subsidized Health Insurance Coverage: Evidence from a Field Experiment," NBER Working Papers 30885, National Bureau of Economic Research, Inc.

    Cited by:

    1. M. Kate Bundorf & Melissa McInerney & Kosali I. Simon & Ruth Winecoff, 2024. "Spillovers in Public Benefit Enrollment: How does Expanding Public Health Insurance for Working-Age Adults affect Future Health Insurance Choices?," NBER Working Papers 32675, National Bureau of Economic Research, Inc.
    2. Steffen Altmann & Andreas Grunewald & Jonas Radbruch, 2024. "The Double Dividend of Attention-Releasing Policies," CESifo Working Paper Series 11069, CESifo.
    3. Steffen Altmann & Andreas Grunewald & Jonas Radbruch, 2024. "The Double Dividend of Nudges," Rationality and Competition Discussion Paper Series 503, CRC TRR 190 Rationality and Competition.
    4. Karl‐Emil Bendtsen, 2026. "Increasing Take‐Up of Social Benefits: A Meta‐Analysis of Field Experiments," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 45(2), March.

  3. Zarek C. Brot-Goldberg & Samantha Burn & Timothy Layton & Boris Vabson, 2023. "Rationing Medicine Through Bureaucracy: Authorization Restrictions in Medicare," NBER Working Papers 30878, National Bureau of Economic Research, Inc.

    Cited by:

    1. Clemens, Jeffrey & Leger, Pierre-Thomas & Nandan, Yashna & Town, Robert, 2026. "Physician practice preferences and healthcare expenditures: Evidence from commercial payers," Journal of Health Economics, Elsevier, vol. 107(C).
    2. Lee, Ajin & Vabson, Boris, 2024. "The value of improving insurance quality: Evidence from long-run Medicaid attrition," Journal of Health Economics, Elsevier, vol. 94(C).
    3. Anderson, David M. & Hoagland, Alex & Zhu, Ed, 2024. "Medical bill shock and imperfect moral hazard," Journal of Public Economics, Elsevier, vol. 236(C).
    4. Ashvin Gandhi & Andrew Olenski & Maggie Shi, 2026. "Predictably Unpredictable Inspections," Working Papers 2026-43, Becker Friedman Institute for Research In Economics.
    5. Marr, Jeffrey, 2025. "Algorithmic decision-making in health care: Evidence from post-acute care in Medicare Advantage," Journal of Health Economics, Elsevier, vol. 104(C).
    6. Carey, Colleen & Daly, Michael & Li, Jing, 2025. "Nothing for something: Marketing cancer drugs to physicians increases prescribing without improving mortality," Journal of Public Economics, Elsevier, vol. 242(C).

  4. Michael Geruso & Timothy Layton & Adam Leive, 2023. "The Incidence of Adverse Selection: Theory and Evidence from Health Insurance Choices," NBER Working Papers 31435, National Bureau of Economic Research, Inc.

    Cited by:

    1. Chen, An & Schelling, Stefan, 2026. "Exploring health improvement incentives through wellness-linked products," Insurance: Mathematics and Economics, Elsevier, vol. 128(C).

  5. Amanda R. Kreider & Timothy J. Layton & Mark Shepard & Jacob Wallace, 2022. "Adverse Selection and Network Design Under Regulated Plan Prices: Evidence from Medicaid," NBER Working Papers 30719, National Bureau of Economic Research, Inc.

    Cited by:

    1. George, Kurian & Minniti, Maria & Rodriguez, Zachary, 2026. "Administered prices and product innovation: Evidence from the wheelchair industry," Technovation, Elsevier, vol. 155(C).

  6. Zarek Brot-Goldberg & Timothy J. Layton & Boris Vabson & Adelina Yanyue Wang, 2021. "The Behavioral Foundations of Default Effects: Theory and Evidence from Medicare Part D," Working Papers 2021-03, Becker Friedman Institute for Research In Economics.

    Cited by:

    1. Christina Gravert, 2024. "From Intent to Inertia: Experimental Evidence from the Retail Electricity Market," CESifo Working Paper Series 11139, CESifo.
    2. Paul Heidhues & Mats Köster & Botond Kőszegi, 2024. "A Theory of Digital Ecosystems," ECONtribute Discussion Papers Series 329, University of Bonn and University of Cologne, Germany.
    3. Tal Gross & Tim Layton & Julia Yates, 2025. "Social defaults and plan choice: The case of spousal following," IFS Working Papers W25/28, Institute for Fiscal Studies.
    4. Kakani, Pragya, 2025. "The impact of vertical integration on health care delivery and costs: Evidence from physician–pharmacy integration," Journal of Health Economics, Elsevier, vol. 104(C).
    5. Henrik Yde Andersen & Camilla Skovbo Christensen & Claus Thustrup Kreiner & Soeren Leth-Petersen, 2025. "Are People Systematically Inactive Across Financial Decisions? Linking Evidence from Mortgage and Retirement Saving Decisions," CEBI working paper series 25-11, University of Copenhagen. Department of Economics. The Center for Economic Behavior and Inequality (CEBI).
    6. Benjamin R. Handel & Kate Ho, 2021. "Industrial Organization of Health Care Markets," NBER Working Papers 29137, National Bureau of Economic Research, Inc.
    7. Abe Dunn & Joshua D. Gottlieb & Adam Hale Shapiro & Daniel J. Sonnenstuhl & Pietro Tebaldi, 2023. "A Denial a Day Keeps the Doctor Away," Working Paper Series 2023-03, Federal Reserve Bank of San Francisco.
    8. Drake, Coleman & Ryan, Conor & Dowd, Bryan, 2022. "Sources of inertia in the individual health insurance market," Journal of Public Economics, Elsevier, vol. 208(C).
    9. Müller, Tobias & Shaikh, Mujaheed & Kauer, Lukas, 2025. "Retirement and health plan choice," Social Science & Medicine, Elsevier, vol. 370(C).
    10. Chlond, Bettina & Goeschl, Timo & Kesternich, Martin & Werthschulte, Madeline, 2024. "Transporting behavioral insights to low-income household: A field experiment on energy efficiency investmen," ZEW Discussion Papers 24-079, ZEW - Leibniz Centre for European Economic Research.
    11. Drake, Coleman & Anderson, David & Cai, Sih-Ting & Sacks, Daniel W., 2023. "Financial transaction costs reduce benefit take-up evidence from zero-premium health insurance plans in Colorado," Journal of Health Economics, Elsevier, vol. 89(C).
    12. Bucher-Koenen, Tabea & Wallossek, Luisa & Winter, Joachim, 2026. "Opt-in or opt-out? The power of defaults in pension enrollment choices," ZEW Discussion Papers 26-014, ZEW - Leibniz Centre for European Economic Research.
    13. Lynn Conell‐Price & Carolyn Kousky & Howard Kunreuther, 2022. "Encouraging resiliency through autoenrollment in supplemental flood insurance coverage," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 89(4), pages 1109-1137, December.
    14. Paul Heidhues & Mats Köster & Botond Kőszegi, 2024. "A Theory of Digital Ecosystems," CESifo Working Paper Series 11332, CESifo.
    15. Choi, Yunji, 2026. "Does $1 matter? Health care demand response to a small copayment," Journal of Public Economics, Elsevier, vol. 257(C).
    16. Bernheim, B. Douglas & Mueller-Gastell, Jonas, 2024. "Optimal default options," Journal of Public Economics, Elsevier, vol. 237(C).
    17. Steffen Altmann & Andreas Grunewald & Jonas Radbruch, 2024. "The Double Dividend of Attention-Releasing Policies," CESifo Working Paper Series 11069, CESifo.
    18. Chlond, Bettina & Goeschl, Timo & Kesternich, Martin & Werthschulte, Madeline, 2024. "Transporting behavioral insights to low-income households: A field experiment on energy efficiency investments," Working Papers 0755, University of Heidelberg, Department of Economics.
    19. Steffen Altmann & Andreas Grunewald & Jonas Radbruch, 2024. "The Double Dividend of Nudges," Rationality and Competition Discussion Paper Series 503, CRC TRR 190 Rationality and Competition.

  7. Michael Geruso & Timothy J. Layton & Jacob Wallace, 2020. "What Difference Does a Health Plan Make? Evidence from Random Plan Assignment in Medicaid," NBER Working Papers 27762, National Bureau of Economic Research, Inc.

    Cited by:

    1. Desai, Sunita M. & Padmanabhan, Prianca & Chen, Alan Z. & Lewis, Ashley & Glied, Sherry A., 2023. "Hospital concentration and low-income populations: Evidence from New York State Medicaid," Journal of Health Economics, Elsevier, vol. 90(C).
    2. Timothy Layton & Ellen J. Montz & Mark Shepard, 2017. "Health Plan Payment in U.S. Marketplaces: Regulated Competition with a Weak Mandate," NBER Working Papers 23444, National Bureau of Economic Research, Inc.
    3. Timothy Layton & Alice K. Ndikumana & Mark Shepard, 2017. "Health Plan Payment in Medicaid Managed Care: A Hybrid Model of Regulated Competition," NBER Working Papers 23518, National Bureau of Economic Research, Inc.
    4. Benjamin R. Handel & Jonathan T. Kolstad, 2021. "The Affordable Care Act After a Decade: Industrial Organization of the Insurance Exchanges," NBER Working Papers 29178, National Bureau of Economic Research, Inc.
    5. Ajin Lee, 2025. "How does Medicaid managed care affect provider behavior? New evidence from spillovers on private health care," Working Papers 202505, University of California at Riverside, Department of Economics.
    6. Layton, Timothy J. & Politzer, Eran, 2025. "The dynamic fiscal costs of outsourcing health insurance - evidence from Medicaid," Journal of Public Economics, Elsevier, vol. 247(C).
    7. Politzer, Eran, 2025. "A change of plans: Switching costs in the procurement of health insurance," Journal of Health Economics, Elsevier, vol. 102(C).
    8. Calvin Ackley & Abe Dunn & Eli Liebman & Adam Hale Shapiro, 2025. "Are Medicaid and Medicare Patients Treated Equally?," Working Paper Series 2024-14, Federal Reserve Bank of San Francisco.
    9. Amitabh Chandra & Evan Flack & Ziad Obermeyer, 2021. "The Health Costs of Cost-Sharing," NBER Working Papers 28439, National Bureau of Economic Research, Inc.

  8. Tal Gross & Timothy Layton & Daniel Prinz, 2020. "The Liquidity Sensitivity of Healthcare Consumption: Evidence from Social Security Payments," NBER Working Papers 27977, National Bureau of Economic Research, Inc.

    Cited by:

    1. Carpenter, Craig & Cotti, Chad, 2026. "The Short-run Effects of Monthly WIC Distributions," 2026 Annual Meeting, July 26 - 28, 2026, Kansas City, Missouri 404589, Agricultural and Applied Economics Association.
    2. Marks, Mindy & Prina, Silvia & Tahaj, Redina, 2024. "Short-term labor supply response to the timing of transfer payments: Evidence from the SNAP program," Labour Economics, Elsevier, vol. 91(C).
    3. Liu, Hong & Ma, Jinqiu & Zhao, Liqiu, 2023. "Public long-term care insurance and consumption of elderly households: Evidence from China," Journal of Health Economics, Elsevier, vol. 90(C).
    4. Yoko Ibuka & Junya Hamaaki, 2024. "Income Receipt, Economic Activities, and Health: Evidence from Ambulance Transport Patterns," Keio-IES Discussion Paper Series 2024-006, Institute for Economics Studies, Keio University.
    5. Daniel Kaliski, 2023. "Identifying the impact of health insurance on subgroups with changing rates of diagnosis," Health Economics, John Wiley & Sons, Ltd., vol. 32(9), pages 2098-2112, September.
    6. Yang, Feng-An & Chang, Hung-Hao, 2023. "Impact of a pension program on healthcare utilization among older farmers: Empirical evidence from health claims data," World Development, Elsevier, vol. 169(C).
    7. Benoît Carré & Florence Jusot & Jérôme Wittwer, 2026. "Do Prices Matter for Healthcare Accessibility? Evidence From a Means‐Tested Complementary Health Insurance in France," Health Economics, John Wiley & Sons, Ltd., vol. 35(4), pages 609-637, April.
    8. Liu, Jiacheng & Wang, Yaojing & Yao, Yi, 2024. "Anticipated benefit termination and health care consumption responses: Evidence from a quasi-experiment," Journal of Economic Behavior & Organization, Elsevier, vol. 227(C).
    9. Timothy K. M. Beatty & Joakim A. Weill, 2024. "Social Security and High-Frequency Labor Supply: Evidence from Uber Drivers," Finance and Economics Discussion Series 2024-079, Board of Governors of the Federal Reserve System (U.S.).
    10. Markus Rieger‐Fels, 2024. "Why do people buy insurance? A modern answer to an old question," Risk Management and Insurance Review, American Risk and Insurance Association, vol. 27(1), pages 89-114, April.
    11. Sun, Jessica Ya, 2025. "Is there moral hazard in medical savings accounts? Evidence from Singapore," Journal of Economic Behavior & Organization, Elsevier, vol. 231(C).
    12. Lovenheim, Michael F. & Yun, Jun Hyun, 2025. "The effect of housing wealth on health care spending," Journal of Health Economics, Elsevier, vol. 103(C).
    13. Guettabi, Mouhcine & Witman, Allison, 2023. "Universal cash transfers and prescription utilization: Evidence from the Alaska permanent fund dividend," Journal of Health Economics, Elsevier, vol. 90(C).
    14. Xinxin Chen & Jin Feng & Zhen Wang & Dandan Yu, 2026. "Insurance Coverage for Chronic Diseases and Healthcare of Low‐Income People: Evidence From Chinese Administrative Data," Health Economics, John Wiley & Sons, Ltd., vol. 35(2), pages 294-311, February.
    15. Carpenter, Craig Wesley & Cotti, Chad, 2026. "Monthly Income Variability and Its Consequences: Evidence from SNAP Administrative Data," 2026 Annual Meeting, July 26 - 28, 2026, Kansas City, Missouri 404593, Agricultural and Applied Economics Association.
    16. Anderson, David M. & Hoagland, Alex & Zhu, Ed, 2024. "Medical bill shock and imperfect moral hazard," Journal of Public Economics, Elsevier, vol. 236(C).
    17. Victor Hernandez Martinez & Kaixin Liu, 2022. "The Value of Unemployment Insurance: Liquidity vs. Insurance Value," Working Papers 22-16, Federal Reserve Bank of Cleveland.
    18. Hoagland, Alex & Wang, Guan, 2025. "Prescribing power and equitable access to care: Evidence from pharmacists in Ontario, Canada," Journal of Health Economics, Elsevier, vol. 103(C).
    19. Nianzhai Ma & Weizeng Sun & Zhen Wang, 2022. "Host Identity and Consumption Behavior: Evidence from Rural–Urban Migrants in China," Sustainability, MDPI, vol. 14(19), pages 1-25, September.
    20. Thomson, Sarah & Cylus, Jonathan & Al Tayara, Lynn & Martínez, Marcos Gallardo & García-Ramírez, Jorge Alejandro & Gregori, María Serrano & Cerezo-Cerezo, José & Karanikolos, Marina & Evetovits, Tamás, 2024. "Monitoring progress towards universal health coverage in Europe: a descriptive analysis of financial protection in 40 countries," LSE Research Online Documents on Economics 122773, London School of Economics and Political Science, LSE Library.
    21. Choi, Yunji, 2026. "Does $1 matter? Health care demand response to a small copayment," Journal of Public Economics, Elsevier, vol. 257(C).
    22. Gelber, Alexander & Moore, Timothy & Pei, Zhuan & Strand, Alexander, 2023. "Disability Insurance Income Saves Lives," University of California at San Diego, Economics Working Paper Series qt3k13m0w3, Department of Economics, UC San Diego.
    23. Carlos Alberto Belchior & Yara Gomes, 2022. "Liquidity constraints, cash transfers and the demand for health care in the Covid‐19 pandemic," Health Economics, John Wiley & Sons, Ltd., vol. 31(11), pages 2369-2380, November.
    24. Jeon, Mimi & Kim, Seonghoon & Koh, Kanghyock, 2025. "Short-term mortality and healthcare utilization consequences of pension income receipt: Evidence from South Korea," Journal of Public Economics, Elsevier, vol. 250(C).
    25. Aurélien Baillon & Owen O'Donnell & Stella Quimbo & Kim van Wilgenburg, 2022. "Do time preferences explain low health insurance take‐up?," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 89(4), pages 951-983, December.
    26. Cylus, Jonathan & Thomson, Sarah & Tayara, Lynn Al & Cerezo, José Cerezo & Martínez, Marcos Gallardo & García-Ramírez, Jorge Alejandro & Karanikolos, Marina & Gregori, María Serrano & Evetovits, Tamás, 2024. "Assessing the equity and coverage policy sensitivity of financial protection indicators in Europe," Health Policy, Elsevier, vol. 147(C).
    27. Amitabh Chandra & Evan Flack & Ziad Obermeyer, 2021. "The Health Costs of Cost-Sharing," NBER Working Papers 28439, National Bureau of Economic Research, Inc.

  9. Geruso, Michael & Layton, Timothy J. & McCormack, Grace & Shepard, Mark, 2019. "The Two Margin Problem in Insurance Markets," Working Paper Series rwp19-035, Harvard University, John F. Kennedy School of Government.

    Cited by:

    1. Richard C. Kleef & Mieke Reuser & Pieter J.A. Stam & Wynand P.M.M. Ven, 2024. "A framework for ex-ante evaluation of the potential effects of risk equalization and risk sharing in health insurance markets with regulated competition," Health Economics Review, Springer, vol. 14(1), pages 1-15, December.
    2. Yann Braouezec & John Cagnol, 2023. "Theoretical Foundations of Community Rating by a Private Monopolist Insurer: Framework, Regulation, and Numerical Analysis," Papers 2309.15269, arXiv.org, revised Dec 2023.
    3. Benjamin R. Handel & Jonathan T. Kolstad, 2021. "The Affordable Care Act After a Decade: Industrial Organization of the Insurance Exchanges," NBER Working Papers 29178, National Bureau of Economic Research, Inc.
    4. Yuyuan Che & Hongli Feng & David A. Hennessy, 2020. "Recency effects and participation at the extensive and intensive margins in the U.S. Federal Crop Insurance Program," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 45(1), pages 52-85, January.
    5. Benjamin R. Handel & Kate Ho, 2021. "Industrial Organization of Health Care Markets," NBER Working Papers 29137, National Bureau of Economic Research, Inc.
    6. Chen, Xiyin & Han, Xinxin & Quan, Jianchao & Bishai, David, 2026. "Adverse selection or beneficial selection in dual western medicine–traditional Chinese medicine insurance markets," Social Science & Medicine, Elsevier, vol. 400(C).
    7. Rory McGee, 2023. "Adverse selection among early adopters and unraveling innovation," IFS Working Papers W23/40, Institute for Fiscal Studies.
    8. Roy McGee, 2023. "Adverse Selection Among Early Adopters and Unraveling Innovation," University of Western Ontario, Centre for Human Capital and Productivity (CHCP) Working Papers 2022302, University of Western Ontario, Centre for Human Capital and Productivity (CHCP).
    9. Chatterjee, Indradeb & Hao, MingJie & Tapadar, Pradip & Thomas, R. Guy, 2024. "Can price collars increase insurance loss coverage?," Insurance: Mathematics and Economics, Elsevier, vol. 116(C), pages 74-94.
    10. Hector Chade & Victoria Marone & Amanda Starc & Jeroen Swinkels, 2026. "Multidimensional Screening for Quality with an Application to Health Insurance," Cowles Foundation Discussion Papers 2541, Cowles Foundation for Research in Economics, Yale University.
    11. Drake, Coleman & Anderson, David & Cai, Sih-Ting & Sacks, Daniel W., 2023. "Financial transaction costs reduce benefit take-up evidence from zero-premium health insurance plans in Colorado," Journal of Health Economics, Elsevier, vol. 89(C).
    12. Florent Nkouaga & Jeffrey Czajkowski & Kelly Edmiston & Brenda Rourke, 2025. "Modeling Behavioral and Attitudinal Drivers of Life Insurance Selection and Premiums: Polynomial Approaches to Perceived Affordability in Term and Cash Value Products," JRFM, MDPI, vol. 18(9), pages 1-33, September.
    13. Zhaowei She & Turgay Ayer & Bilal Gokpinar & Danny R. Hughes, 2024. "Strategic Cross-Subsidization in Healthcare Capitation Programs: Evidence from Medicare Advantage," Manufacturing & Service Operations Management, INFORMS, vol. 26(6), pages 2085-2101, November.
    14. Fleitas, Sebastian & Gowrisankaran, Gautam & Lo Sasso, Anthony, 2022. "Incumbent regulation and adverse selection: You can keep your health plan, but at what cost?," Journal of Public Economics, Elsevier, vol. 205(C).
    15. Timothy F. Harris & Aaron Yelowitz & Jeffery Talbert & Alison Davis, 2023. "Adverse selection in the group life insurance market," Economic Inquiry, Western Economic Association International, vol. 61(4), pages 911-941, October.
    16. Richard Domurat & Isaac Menashe & Wesley Yin, 2019. "The Role of Behavioral Frictions in Health Insurance Marketplace Enrollment and Risk: Evidence from a Field Experiment," NBER Working Papers 26153, National Bureau of Economic Research, Inc.

  10. Timothy J. Layton & Nicole Maestas & Daniel Prinz & Boris Vabson, 2019. "Private vs. Public Provision of Social Insurance: Evidence from Medicaid," NBER Working Papers 26042, National Bureau of Economic Research, Inc.

    Cited by:

    1. Lee, Ajin & Vabson, Boris, 2024. "The value of improving insurance quality: Evidence from long-run Medicaid attrition," Journal of Health Economics, Elsevier, vol. 94(C).
    2. Ajin Lee, 2025. "How does Medicaid managed care affect provider behavior? New evidence from spillovers on private health care," Working Papers 202505, University of California at Riverside, Department of Economics.
    3. Lee, Ajin, 2020. "How do hospitals respond to managed care? Evidence from at-risk newborns," Journal of Public Economics, Elsevier, vol. 184(C).
    4. Juan Pablo Atala & José Ignacio Cuesta & Felipe González & Cristóbal Otero, 2021. "The Economics of the Public Option: Evidence from Local Pharmaceutical Markets," Documentos de Trabajo 561, Instituto de Economia. Pontificia Universidad Católica de Chile..

  11. Savannah L. Bergquist & Timothy J. Layton & Thomas G. McGuire & Sherri Rose, 2018. "Intervening on the Data to Improve the Performance of Health Plan Payment Methods," NBER Working Papers 24491, National Bureau of Economic Research, Inc.

    Cited by:

    1. Layton, Timothy J. & McGuire, Thomas G. & van Kleef, Richard C., 2018. "Deriving risk adjustment payment weights to maximize efficiency of health insurance markets," Journal of Health Economics, Elsevier, vol. 61(C), pages 93-110.

  12. Michael Geruso & Timothy Layton, 2017. "Selection in Health Insurance Markets and Its Policy Remedies," NBER Working Papers 23876, National Bureau of Economic Research, Inc.

    Cited by:

    1. Camilo Arias, 2026. "Selecting risk adjusters with penalized regression and expert judgment: evidence from Colombia," Health Economics Review, Springer, vol. 16(1), pages 1-30, December.
    2. Keaton S. Miller & Amil Petrin & Robert Town & Michael Chernew, 2019. "The Optimal Geographic Distribution of Managed Competition Subsidies," NBER Working Papers 25616, National Bureau of Economic Research, Inc.
    3. Jing Jian Xiao & Chunsheng Tao, 2020. "Consumer finance/household finance: the definition and scope," China Finance Review International, Emerald Group Publishing Limited, vol. 11(1), pages 1-25, June.
    4. Zaid Hattab & Edel Doherty & Andrew M Ryan & Stephen O’Neill, 2024. "Heterogeneity within the Oregon Health Insurance Experiment: An application of causal forests," PLOS ONE, Public Library of Science, vol. 19(1), pages 1-21, January.
    5. Gemmo, Irina & Kubitza, Christian & Rothschild, Casey, 2020. "Constrained efficient equilibria in selection markets with continuous types," Journal of Public Economics, Elsevier, vol. 190(C).
    6. Timothy J. Layton & Nicole Maestas & Daniel Prinz & Boris Vabson, 2019. "Private vs. Public Provision of Social Insurance: Evidence from Medicaid," NBER Working Papers 26042, National Bureau of Economic Research, Inc.
    7. Layton, Timothy J. & McGuire, Thomas G. & van Kleef, Richard C., 2018. "Deriving risk adjustment payment weights to maximize efficiency of health insurance markets," Journal of Health Economics, Elsevier, vol. 61(C), pages 93-110.
    8. Minke Remmerswaal & Jan Boone & Rudy Douven, 2019. "Selection and moral hazard effects in healthcare," CPB Discussion Paper 393, CPB Netherlands Bureau for Economic Policy Analysis.
    9. Tuukka Holster & Shaoxiong Ji & Pekka Marttinen, 2024. "Risk adjustment for regional healthcare funding allocations with ensemble methods: an empirical study and interpretation," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 25(7), pages 1117-1131, September.
    10. Curto, Vilsa E., 2023. "Pricing regulations in individual health insurance: Evidence from Medigap," Journal of Health Economics, Elsevier, vol. 91(C).
    11. Moiz Bhai & Danny R. Hughes, 2026. "Estimating Self‐Selection in Medicare Advantage," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 45(2), March.
    12. Daniel Garcia & Roee Teper & Matan Tsur, 2018. "Information Design in Insurance Markets: Selling Peaches in a Market for Lemons," CESifo Working Paper Series 6853, CESifo.
    13. Benjamin R. Handel & Kate Ho, 2021. "Industrial Organization of Health Care Markets," NBER Working Papers 29137, National Bureau of Economic Research, Inc.
    14. Olivier Darmouni & Dan Zeltzer, 2022. "Horizon effects and adverse selection in health insurance markets," Canadian Journal of Economics/Revue canadienne d'économique, John Wiley & Sons, vol. 55(2), pages 800-827, May.
    15. Casey Rothschild, 2024. "Welfare analysis in insurance markets," The Geneva Risk and Insurance Review, Palgrave Macmillan;International Association for the Study of Insurance Economics (The Geneva Association), vol. 49(1), pages 36-58, March.
    16. Damon Jones & David Molitor & Julian Reif, 2018. "What Do Workplace Wellness Programs Do? Evidence from the Illinois Workplace Wellness Study," NBER Working Papers 24229, National Bureau of Economic Research, Inc.
    17. Eklund, Jesse, 2021. "Evidence from the Medical Expenditure Panel Survey on Patient Cost of Care Provided by Nurse Practitioners," Master's Theses and Plan B Papers 309652, University of Minnesota, Department of Applied Economics.
    18. Rory McGee, 2023. "Adverse selection among early adopters and unraveling innovation," IFS Working Papers W23/40, Institute for Fiscal Studies.
    19. Roy McGee, 2023. "Adverse Selection Among Early Adopters and Unraveling Innovation," University of Western Ontario, Centre for Human Capital and Productivity (CHCP) Working Papers 2022302, University of Western Ontario, Centre for Human Capital and Productivity (CHCP).
    20. Zwart, Gijsbert, 2025. "Moral hazard and risk adjustment," Journal of Health Economics, Elsevier, vol. 99(C).
    21. Remmerswaal, Minke & Boone, Jan & Douven, Rudy, 2023. "Minimum generosity levels in a competitive health insurance market," Journal of Health Economics, Elsevier, vol. 90(C).
    22. Zhaowei She & Turgay Ayer & Daniel Montanera, 2022. "Can Big Data Cure Risk Selection in Healthcare Capitation Program? A Game Theoretical Analysis," Manufacturing & Service Operations Management, INFORMS, vol. 24(6), pages 3117-3134, November.
    23. Diego Cerecero-García & Octavio Gómez-Dantés & Thomas Hone & Carlos Pineda-Antúnez & Alejandro Mohar-Betancourt & Laura Flamand & Edson Serván-Mori, 2026. "Catastrophic and impoverishing health expenditures in fragmented public health systems: lessons from Mexico, 2000–2022," Health Economics Review, Springer, vol. 16(1), pages 1-17, December.
    24. Anna Jędrzychowska, 2022. "A Bridge Life Insurance for Households—Diagnosis and Motives," Risks, MDPI, vol. 10(4), pages 1-21, April.
    25. Amanda R. Kreider & Timothy J. Layton & Mark Shepard & Jacob Wallace, 2022. "Adverse Selection and Network Design Under Regulated Plan Prices: Evidence from Medicaid," NBER Working Papers 30719, National Bureau of Economic Research, Inc.
    26. Zhaowei She & Turgay Ayer & Bilal Gokpinar & Danny R. Hughes, 2024. "Strategic Cross-Subsidization in Healthcare Capitation Programs: Evidence from Medicare Advantage," Manufacturing & Service Operations Management, INFORMS, vol. 26(6), pages 2085-2101, November.
    27. Richard Domurat & Isaac Menashe & Wesley Yin, 2019. "The Role of Behavioral Frictions in Health Insurance Marketplace Enrollment and Risk: Evidence from a Field Experiment," NBER Working Papers 26153, National Bureau of Economic Research, Inc.
    28. Ding, Hui & Wang, Xintong & Xu, Xian, 2026. "The impact of public-private partnership health plans on private insurance," Journal of Development Economics, Elsevier, vol. 182(C).
    29. Shuli Brammli-Greenberg & Jacob Glazer & Ruth Waitzberg, 2019. "Modest risk-sharing significantly reduces health plans’ incentives for service distortion," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(9), pages 1359-1374, December.
    30. Georges Dionne & Nathalie Fombaron & Wanda Mimra, 2023. "Adverse selection in insurance," Working Papers 23-5, HEC Montreal, Canada Research Chair in Risk Management.

  13. Timothy Layton & Ellen J. Montz & Mark Shepard, 2017. "Health Plan Payment in U.S. Marketplaces: Regulated Competition with a Weak Mandate," NBER Working Papers 23444, National Bureau of Economic Research, Inc.

    Cited by:

    1. Thomas G. McGuire & Sonja Schillo & Richard C. van Kleef, 2018. "Reinsurance, Repayments, and Risk Adjustment in Individual Health Insurance: Germany, The Netherlands and the U.S. Marketplaces," NBER Working Papers 25374, National Bureau of Economic Research, Inc.
    2. Michael Geruso & Timothy Layton, 2017. "Selection in Health Insurance Markets and Its Policy Remedies," NBER Working Papers 23876, National Bureau of Economic Research, Inc.
    3. Sherri Rose & Thomas G. McGuire, 2018. "Limitations of P-Values and $R^2$ for Stepwise Regression Building: A Fairness Demonstration in Health Policy Risk Adjustment," Papers 1803.05513, arXiv.org, revised Aug 2018.
    4. Maria Polyakova & Stephen P. Ryan, 2019. "Subsidy Targeting with Market Power," NBER Working Papers 26367, National Bureau of Economic Research, Inc.

  14. Timothy Layton & Alice K. Ndikumana & Mark Shepard, 2017. "Health Plan Payment in Medicaid Managed Care: A Hybrid Model of Regulated Competition," NBER Working Papers 23518, National Bureau of Economic Research, Inc.

    Cited by:

    1. Keith Marzilli Ericson & Kimberley Geissler & Benjamin Lubin, 2017. "The Impact of Partial-Year Enrollment on the Accuracy of Risk Adjustment Systems: A Framework and Evidence," NBER Working Papers 23765, National Bureau of Economic Research, Inc.
    2. Amanda R. Kreider & Timothy J. Layton & Mark Shepard & Jacob Wallace, 2022. "Adverse Selection and Network Design Under Regulated Plan Prices: Evidence from Medicaid," NBER Working Papers 30719, National Bureau of Economic Research, Inc.

  15. Michael Geruso & Timothy J. Layton & Daniel Prinz, 2016. "Screening in Contract Design: Evidence from the ACA Health Insurance Exchanges," NBER Working Papers 22832, National Bureau of Economic Research, Inc.

    Cited by:

    1. Bijlsma, Michiel & Boone, Jan & Zwart, Gijsbert, 2017. "The complementarity between risk adjustment and community rating: Distorting market outcomes to facilitate redistribution," Journal of Public Economics, Elsevier, vol. 155(C), pages 21-37.
    2. Michele Fioretti & Hongming Wang, 2019. "Subsidizing Inequality: Performance Pay and Risk Selection in Medicare," Sciences Po Economics Discussion Papers hal-03393070, HAL.
    3. Michele Fioretti & Hongming Wang, 2021. "Performance Pay in Insurance Markets: Evidence from Medicare," Post-Print hal-03791843, HAL.
    4. David Dranove & Christopher Ody & Amanda Starc, 2017. "A Dose of Managed Care: Controlling Drug Spending in Medicaid," NBER Working Papers 23956, National Bureau of Economic Research, Inc.
    5. Jason Abaluck & Mauricio Caceres Bravo & Peter Hull & Amanda Starc, 2020. "Mortality Effects and Choice Across Private Health Insurance Plans," Working Papers 2020-108, Becker Friedman Institute for Research In Economics.
    6. Michael J. Dickstein & Kate Ho & Nathaniel Mark, 2021. "Market Segmentation and Competition in Health Insurance," Working Papers 2021-93, Princeton University. Economics Department..
    7. Josh Feng & Luca Maini, 2024. "Demand Inertia and the Hidden Impact of Pharmacy Benefit Managers," Management Science, INFORMS, vol. 70(12), pages 8940-8961, December.
    8. Michael Geruso & Timothy Layton, 2017. "Selection in Health Insurance Markets and Its Policy Remedies," NBER Working Papers 23876, National Bureau of Economic Research, Inc.
    9. Keith Marzilli Ericson & Kimberley Geissler & Benjamin Lubin, 2017. "The Impact of Partial-Year Enrollment on the Accuracy of Risk Adjustment Systems: A Framework and Evidence," NBER Working Papers 23765, National Bureau of Economic Research, Inc.
    10. Timothy Layton & Ellen J. Montz & Mark Shepard, 2017. "Health Plan Payment in U.S. Marketplaces: Regulated Competition with a Weak Mandate," NBER Working Papers 23444, National Bureau of Economic Research, Inc.
    11. Nathaniel Hendren & Camille Landais & Johannes Spinnewijn, 2021. "Choice in Insurance Markets: A Pigouvian Approach to Social Insurance Design," Annual Review of Economics, Annual Reviews, vol. 13(1), pages 457-486, August.
    12. Withagen-Koster, Anja A. & van Kleef, Richard C. & Eijkenaar, Frank, 2023. "Predictable profits and losses in a health insurance market with risk equalization: A multiple-contract period perspective," Health Policy, Elsevier, vol. 131(C).
    13. Bergquist, Savannah L. & Layton, Timothy J. & McGuire, Thomas G. & Rose, Sherri, 2019. "Data transformations to improve the performance of health plan payment methods," Journal of Health Economics, Elsevier, vol. 66(C), pages 195-207.
    14. Giampiero Marra & Rosalba Radice & David Zimmer, 2021. "Did the ACA's “guaranteed issue” provision cause adverse selection into nongroup insurance? Analysis using a copula‐based hurdle model," Health Economics, John Wiley & Sons, Ltd., vol. 30(9), pages 2246-2263, September.
    15. Tuukka Holster & Shaoxiong Ji & Pekka Marttinen, 2024. "Risk adjustment for regional healthcare funding allocations with ensemble methods: an empirical study and interpretation," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 25(7), pages 1117-1131, September.
    16. Michael Geruso & Timothy J. Layton & Grace McCormack & Mark Shepard, 2019. "The Two Margin Problem in Insurance Markets," NBER Working Papers 26288, National Bureau of Economic Research, Inc.
    17. Maria Polyakova & Stephen P. Ryan, 2019. "Subsidy Targeting with Market Power," NBER Working Papers 26367, National Bureau of Economic Research, Inc.
    18. Benjamin R. Handel & Jonathan T. Kolstad, 2021. "The Affordable Care Act After a Decade: Industrial Organization of the Insurance Exchanges," NBER Working Papers 29178, National Bureau of Economic Research, Inc.
    19. Thomas G. McGuire & Anna L. Zink & Sherri Rose, 2020. "Simplifying and Improving the Performance of Risk Adjustment Systems," NBER Working Papers 26736, National Bureau of Economic Research, Inc.
    20. Benjamin R. Handel & Kate Ho, 2021. "Industrial Organization of Health Care Markets," NBER Working Papers 29137, National Bureau of Economic Research, Inc.
    21. Olivier Darmouni & Dan Zeltzer, 2022. "Horizon effects and adverse selection in health insurance markets," Canadian Journal of Economics/Revue canadienne d'économique, John Wiley & Sons, vol. 55(2), pages 800-827, May.
    22. Joseph P. Newhouse & Mary Beth Landrum & Mary Price & J. Michael McWilliams & John Hsu & Thomas McGuire, 2018. "The Comparative Advantage of Medicare Advantage," NBER Working Papers 24289, National Bureau of Economic Research, Inc.
    23. Evan Saltzman, 2021. "Managing adverse selection: underinsurance versus underenrollment," RAND Journal of Economics, RAND Corporation, vol. 52(2), pages 359-381, June.
    24. Peter Paul Klein & Richard van Kleef & Josefa Henriquez & Francesco Paolucci, 2023. "The interplay between risk adjustment and risk rating in voluntary health insurance," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 90(1), pages 59-91, March.
    25. A. A. Withagen-Koster & R. C. Kleef & F. Eijkenaar, 2020. "Incorporating self-reported health measures in risk equalization through constrained regression," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(4), pages 513-528, June.
    26. Richard C. van Kleef & René C. J. A. van Vliet, 2022. "How to deal with persistently low/high spenders in health plan payment systems?," Health Economics, John Wiley & Sons, Ltd., vol. 31(5), pages 784-805, May.
    27. Zwart, Gijsbert, 2025. "Moral hazard and risk adjustment," Journal of Health Economics, Elsevier, vol. 99(C).
    28. Jeffrey P. Clemens & Jonathan M. Leganza & Alex Masucci, 2021. "Plugging Gaps in Payment Systems: Evidence from the Take-Up of New Medicare Billing Codes," CESifo Working Paper Series 9209, CESifo.
    29. Daniel W. Sacks & Khoa Vu & Tsan-Yao Huang & Pinar Karaca-Mandic, 2017. "How do insurance firms respond to financial risk sharing regulations? Evidence from the Affordable Care Act," NBER Working Papers 24129, National Bureau of Economic Research, Inc.
    30. Savannah L. Bergquist & Timothy J. Layton & Thomas G. McGuire & Sherri Rose, 2018. "Intervening on the Data to Improve the Performance of Health Plan Payment Methods," NBER Working Papers 24491, National Bureau of Economic Research, Inc.
    31. Amanda R. Kreider & Timothy J. Layton & Mark Shepard & Jacob Wallace, 2022. "Adverse Selection and Network Design Under Regulated Plan Prices: Evidence from Medicaid," NBER Working Papers 30719, National Bureau of Economic Research, Inc.
    32. Jonathan Gruber, 2017. "Delivering Public Health Insurance through Private Plan Choice in the United States," Journal of Economic Perspectives, American Economic Association, vol. 31(4), pages 3-22, Fall.
    33. Fleitas, Sebastian & Gowrisankaran, Gautam & Lo Sasso, Anthony, 2022. "Incumbent regulation and adverse selection: You can keep your health plan, but at what cost?," Journal of Public Economics, Elsevier, vol. 205(C).
    34. Daniel W. Sacks & Khoa Vu & Tsan‐Yao Huang & Pinar Karaca‐Mandic, 2021. "How do insurance firms respond to financial risk sharing regulations? Evidence from the Affordable Care Act," Health Economics, John Wiley & Sons, Ltd., vol. 30(6), pages 1443-1460, June.
    35. Lieber, Ethan M.J., 2018. "Does health insurance coverage fall when nonprofit insurers become for-profits?," Journal of Health Economics, Elsevier, vol. 57(C), pages 75-88.
    36. Sylvia Klosin & Adam Solomon, 2026. "Unpriced Diversification in US Crop Insurance," NBER Chapters, in: Risk and Risk Management in the Agricultural Economy, National Bureau of Economic Research, Inc.
    37. Anna Zink & Sherri Rose, 2020. "Fair regression for health care spending," Biometrics, The International Biometric Society, vol. 76(3), pages 973-982, September.
    38. Cici McNamara & Natalia Serna, 2022. "The impact of a national formulary expansion on diabetics," Health Economics, John Wiley & Sons, Ltd., vol. 31(11), pages 2311-2332, November.

  16. Timothy J. Layton & Thomas G. McGuire, 2016. "Marketplace Plan Payment Options for Dealing with High-Cost Enrollees," NBER Working Papers 22519, National Bureau of Economic Research, Inc.

    Cited by:

    1. Thomas G. McGuire & Sonja Schillo & Richard C. van Kleef, 2018. "Reinsurance, Repayments, and Risk Adjustment in Individual Health Insurance: Germany, The Netherlands and the U.S. Marketplaces," NBER Working Papers 25374, National Bureau of Economic Research, Inc.
    2. Timothy Layton & Ellen J. Montz & Mark Shepard, 2017. "Health Plan Payment in U.S. Marketplaces: Regulated Competition with a Weak Mandate," NBER Working Papers 23444, National Bureau of Economic Research, Inc.
    3. Maria Polyakova & Stephen P. Ryan, 2019. "Subsidy Targeting with Market Power," NBER Working Papers 26367, National Bureau of Economic Research, Inc.
    4. Thomas G. McGuire & Anna L. Zink & Sherri Rose, 2020. "Simplifying and Improving the Performance of Risk Adjustment Systems," NBER Working Papers 26736, National Bureau of Economic Research, Inc.
    5. Thomas G. McGuire & Sonja Schillo & Richard C. Kleef, 2021. "Very high and low residual spenders in private health insurance markets: Germany, The Netherlands and the U.S. Marketplaces," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(1), pages 35-50, February.

  17. Timothy J. Layton & Thomas G. McGuire & Richard C. van Kleef, 2016. "Deriving Risk Adjustment Payment Weights to Maximize Efficiency of Health Insurance Markets," NBER Working Papers 22642, National Bureau of Economic Research, Inc.

    Cited by:

    1. Pilny, Adam & Wübker, Ansgar & Ziebarth, Nicolas R., 2017. "Introducing Risk Adjustment and Free Health Plan Choice in Employer-Based Health Insurance: Evidence from Germany," VfS Annual Conference 2017 (Vienna): Alternative Structures for Money and Banking 168121, Verein für Socialpolitik / German Economic Association.
    2. Shobhit Kulshreshtha & Martin Salm & Ansgar Wübker, 2025. "Health drain: the effect of internal migration on regional disparities in healthcare costs," Journal of Population Economics, Springer;European Society for Population Economics, vol. 38(3), pages 1-28, September.
    3. Carey, Colleen, 2021. "Sharing the burden of subsidization: Evidence on pass-through from a subsidy revision in Medicare Part D," Journal of Public Economics, Elsevier, vol. 198(C).
    4. Thomas G. McGuire & Sonja Schillo & Richard C. van Kleef, 2018. "Reinsurance, Repayments, and Risk Adjustment in Individual Health Insurance: Germany, The Netherlands and the U.S. Marketplaces," NBER Working Papers 25374, National Bureau of Economic Research, Inc.
    5. Wynand P. M. M. Ven & Richard C. Kleef, 2025. "A critical review of the use of R2 in risk equalization research," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 26(3), pages 363-375, April.
    6. Michael Geruso & Timothy Layton, 2017. "Selection in Health Insurance Markets and Its Policy Remedies," NBER Working Papers 23876, National Bureau of Economic Research, Inc.
    7. Bergquist, Savannah L. & Layton, Timothy J. & McGuire, Thomas G. & Rose, Sherri, 2019. "Data transformations to improve the performance of health plan payment methods," Journal of Health Economics, Elsevier, vol. 66(C), pages 195-207.
    8. Sherri Rose & Thomas G. McGuire, 2019. "Limitations of P-Values and R-squared for Stepwise Regression Building: A Fairness Demonstration in Health Policy Risk Adjustment," The American Statistician, Taylor & Francis Journals, vol. 73(S1), pages 152-156, March.
    9. Kulshreshtha, Shobhit & Salm, Martin & Wübker, Ansgar, 2022. "Does population sorting through internal migration increase healthcare costs and needs in peripheral regions?," Ruhr Economic Papers 970, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    10. Sherri Rose & Thomas G. McGuire, 2018. "Limitations of P-Values and $R^2$ for Stepwise Regression Building: A Fairness Demonstration in Health Policy Risk Adjustment," Papers 1803.05513, arXiv.org, revised Aug 2018.
    11. Constantinou, Panayotis & Tuppin, Philippe & Gastaldi-Ménager, Christelle & Pelletier-Fleury, Nathalie, 2022. "Defining a risk-adjustment formula for the introduction of population-based payments for primary care in France," Health Policy, Elsevier, vol. 126(9), pages 915-924.
    12. Laura Anselmi & Yiu-Shing Lau & Matt Sutton & Anna Everton & Rob Shaw & Stephen Lorrimer, 2022. "Use of past care markers in risk-adjustment: accounting for systematic differences across providers," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(1), pages 133-151, February.
    13. Joseph P. Newhouse & Mary Beth Landrum & Mary Price & J. Michael McWilliams & John Hsu & Thomas McGuire, 2018. "The Comparative Advantage of Medicare Advantage," NBER Working Papers 24289, National Bureau of Economic Research, Inc.
    14. A. A. Withagen-Koster & R. C. Kleef & F. Eijkenaar, 2020. "Incorporating self-reported health measures in risk equalization through constrained regression," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(4), pages 513-528, June.
    15. Richard C. van Kleef & René C. J. A. van Vliet, 2022. "How to deal with persistently low/high spenders in health plan payment systems?," Health Economics, John Wiley & Sons, Ltd., vol. 31(5), pages 784-805, May.
    16. Zwart, Gijsbert, 2025. "Moral hazard and risk adjustment," Journal of Health Economics, Elsevier, vol. 99(C).
    17. Kulshreshtha, Shobhit & Salm, Martin & Wübker, Ansgar, 2022. "Does Population Sorting through Internal Migration Increase Healthcare Costs and Needs in Peripheral Regions?," IZA Discussion Papers 15559, IZA Network @ LISER.
    18. Thomas G. McGuire & Sonja Schillo & Richard C. Kleef, 2021. "Very high and low residual spenders in private health insurance markets: Germany, The Netherlands and the U.S. Marketplaces," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(1), pages 35-50, February.
    19. Savannah L. Bergquist & Timothy J. Layton & Thomas G. McGuire & Sherri Rose, 2018. "Intervening on the Data to Improve the Performance of Health Plan Payment Methods," NBER Working Papers 24491, National Bureau of Economic Research, Inc.
    20. Simon Reif & Sabrina Schubert & Achim Wambach, 2025. "Setting incentives right with long-term risk adjustment," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 26(2), pages 147-151, March.
    21. Michel Oskam & Richard C. van Kleef & René C. J. A. van Vliet, 2023. "Improving diagnosis-based cost groups in the Dutch risk equalization model: the effects of a new clustering method and allowing for multimorbidity," International Journal of Health Economics and Management, Springer, vol. 23(2), pages 303-324, June.
    22. Ayman Fouda & Gianluca Fiorentini & Francesco Paolucci, 2017. "Competitive Health Markets and Risk Equalisation in Australia: Lessons Learnt from Other Countries," Applied Health Economics and Health Policy, Springer, vol. 15(6), pages 745-754, December.

  18. Michael Geruso & Timothy Layton, 2015. "Upcoding: Evidence from Medicare on Squishy Risk Adjustment," NBER Working Papers 21222, National Bureau of Economic Research, Inc.

    Cited by:

    1. Bijlsma, Michiel & Boone, Jan & Zwart, Gijsbert, 2017. "The complementarity between risk adjustment and community rating: Distorting market outcomes to facilitate redistribution," Journal of Public Economics, Elsevier, vol. 155(C), pages 21-37.
    2. George Stoye & Ben Zaranko, 2020. "How accurate are self-reported diagnoses? Comparing self-reported health events in the English Longitudinal Study of Ageing with administrative hospital records," IFS Working Papers W20/13, Institute for Fiscal Studies.
    3. Ikegami, Kei & Onishi, Ken & Wakamori, Naoki, 2021. "Competition-driven physician-induced demand," Journal of Health Economics, Elsevier, vol. 79(C).
    4. Sebastian Bauhoff & Lisa Fischer & Dirk Göpffarth & Amelie C. Wuppermann, 2017. "Plan Responses to Diagnosis-Based Payment: Evidence from Germany's Morbidity-Based Risk Adjustment," CESifo Working Paper Series 6507, CESifo.
    5. Keaton S. Miller & Amil Petrin & Robert Town & Michael Chernew, 2019. "The Optimal Geographic Distribution of Managed Competition Subsidies," NBER Working Papers 25616, National Bureau of Economic Research, Inc.
    6. Daniel Kaliski, 2023. "Identifying the impact of health insurance on subgroups with changing rates of diagnosis," Health Economics, John Wiley & Sons, Ltd., vol. 32(9), pages 2098-2112, September.
    7. Jin, Ginger Zhe & Lien, Hsienming & Tao, Xuezhen, 2025. "Top-up design and health care expenditure: Evidence from cardiac stents," China Economic Review, Elsevier, vol. 93(C).
    8. Colleen Carey, 2017. "Technological Change and Risk Adjustment: Benefit Design Incentives in Medicare Part D," American Economic Journal: Economic Policy, American Economic Association, vol. 9(1), pages 38-73, February.
    9. Richard C. Kleef & Thomas G. McGuire & René C. J. A. Vliet & Wynand P. P. M. de Ven, 2017. "Improving risk equalization with constrained regression," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(9), pages 1137-1156, December.
    10. Hanming Fang & Qing Gong, 2017. "Detecting Potential Overbilling in Medicare Reimbursement via Hours Worked," American Economic Review, American Economic Association, vol. 107(2), pages 562-591, February.
    11. Timothy J. Layton & Randall P. Ellis & Thomas G. McGuire, 2015. "Assessing Incentives for Adverse Selection in Health Plan Payment Systems," NBER Working Papers 21531, National Bureau of Economic Research, Inc.
    12. Michael Geruso & Timothy Layton, 2017. "Selection in Health Insurance Markets and Its Policy Remedies," NBER Working Papers 23876, National Bureau of Economic Research, Inc.
    13. Keith Marzilli Ericson & Kimberley Geissler & Benjamin Lubin, 2017. "The Impact of Partial-Year Enrollment on the Accuracy of Risk Adjustment Systems: A Framework and Evidence," NBER Working Papers 23765, National Bureau of Economic Research, Inc.
    14. Benjamin Handel & Nianyi Hong & Lynn M. Hua & Yuki Ito, 2023. "Employer risk‐adjustment transitions with inertial consumers: Evidence from CalPERS," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 90(1), pages 93-121, March.
    15. Naoki Aizawa & You Suk Kim, 2015. "Advertising and Risk Selection in Health Insurance Markets," Finance and Economics Discussion Series 2015-101, Board of Governors of the Federal Reserve System (U.S.).
    16. Randall P. Ellis & Wenjia Zhu, 2015. "Health Plan Type Variations in Spells of Health Care Treatment," Boston University - Department of Economics - Working Papers Series wp2015-022, Boston University - Department of Economics.
    17. Kurt Lavetti & Kosali Simon, 2016. "Strategic Formulary Design in Medicare Part D Plans," NBER Working Papers 22338, National Bureau of Economic Research, Inc.
    18. Adam Sacarny, 2018. "Adoption and Learning Across Hospitals: The Case of a Revenue-Generating Practice," NBER Working Papers 24497, National Bureau of Economic Research, Inc.
    19. Benjamin Vatter, 2025. "Quality Disclosure and Regulation: Scoring Design in Medicare Advantage," Econometrica, Econometric Society, vol. 93(3), pages 959-1001, May.
    20. Kanghyock Koh & Sungchul Park, 2025. "Effects of the Medicaid coverage cliff on low‐income elderly Medicare beneficiaries," Health Economics, John Wiley & Sons, Ltd., vol. 34(1), pages 105-153, January.
    21. Layton, Timothy J. & McGuire, Thomas G. & van Kleef, Richard C., 2018. "Deriving risk adjustment payment weights to maximize efficiency of health insurance markets," Journal of Health Economics, Elsevier, vol. 61(C), pages 93-110.
    22. Cook, Amanda & Averett, Susan, 2020. "Do hospitals respond to changing incentive structures? Evidence from Medicare’s 2007 DRG restructuring," Journal of Health Economics, Elsevier, vol. 73(C).
    23. Julie Shi & Yi Yao & Gordon Liu, 2018. "Modeling individual health care expenditures in China: Evidence to assist payment reform in public insurance," Health Economics, John Wiley & Sons, Ltd., vol. 27(12), pages 1945-1962, December.
    24. Josefa Henriquez & Marica Iommi & Thomas McGuire & Emmanouil Mentzakis & Francesco Paolucci, 2023. "Designing feasible and effective health plan payments in countries with data availability constraints," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 90(1), pages 33-57, March.
    25. Michael Geruso & Timothy J. Layton & Grace McCormack & Mark Shepard, 2019. "The Two Margin Problem in Insurance Markets," NBER Working Papers 26288, National Bureau of Economic Research, Inc.
    26. Moiz Bhai & Danny R. Hughes, 2026. "Estimating Self‐Selection in Medicare Advantage," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 45(2), March.
    27. Francesco Decarolis & Andrea Guglielmo, 2016. "Insurers' Response to Selection Risk: Evidence from Medicare Enrollment Reforms," NBER Working Papers 22876, National Bureau of Economic Research, Inc.
    28. Anders Anell & Margareta Dackehag & Jens Dietrichson & Lina Maria Ellegård & Gustav Kjellsson, 2025. "Better off by risk adjustment? Socioeconomic disparities in care utilization in Sweden following a payment reform," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 44(3), pages 836-868, June.
    29. Benjamin R. Handel & Jonathan T. Kolstad, 2021. "The Affordable Care Act After a Decade: Industrial Organization of the Insurance Exchanges," NBER Working Papers 29178, National Bureau of Economic Research, Inc.
    30. Nicholas Benson & Jose Joaquin Lopez, 2024. "Surgeons' response to reimbursement changes for alternative procedures: Evidence from spine fusion in the U.S," Contemporary Economic Policy, Western Economic Association International, vol. 42(1), pages 41-55, January.
    31. Marica Iommi & Savannah Bergquist & Gianluca Fiorentini & Francesco Paolucci, 2022. "Comparing risk adjustment estimation methods under data availability constraints," Health Economics, John Wiley & Sons, Ltd., vol. 31(7), pages 1368-1380, July.
    32. Thomas G. McGuire & Anna L. Zink & Sherri Rose, 2020. "Simplifying and Improving the Performance of Risk Adjustment Systems," NBER Working Papers 26736, National Bureau of Economic Research, Inc.
    33. Jonathan Gruber & Benjamin R. Handel & Samuel H. Kina & Jonathan T. Kolstad, 2020. "Managing Intelligence: Skilled Experts and AI in Markets for Complex Products," NBER Working Papers 27038, National Bureau of Economic Research, Inc.
    34. Timothy J. Layton & Thomas G. McGuire, 2017. "Marketplace Plan Payment Options for Dealing with High-Cost Enrollees," American Journal of Health Economics, MIT Press, vol. 3(2), pages 165-191, Spring.
    35. Vilsa Curto & Liran Einav & Amy Finkelstein & Jonathan Levin & Jay Bhattacharya, 2019. "Health Care Spending and Utilization in Public and Private Medicare," American Economic Journal: Applied Economics, American Economic Association, vol. 11(2), pages 302-332, April.
    36. Simón Ramírez Amaya & Adolfo J. Quiroz & �lvaro Jos� Riascos Villegas, 2019. "Regression by clustering using metropolis-hastings," Documentos de Trabajo 18180, Quantil.
    37. Benjamin R. Handel & Kate Ho, 2021. "Industrial Organization of Health Care Markets," NBER Working Papers 29137, National Bureau of Economic Research, Inc.
    38. Lai, Yi & Fu, Hongqiao & Li, Ling & Yip, Winnie, 2022. "Hospital response to a case-based payment scheme under regional global budget: The case of Guangzhou in China," Social Science & Medicine, Elsevier, vol. 292(C).
    39. Joseph P. Newhouse & Mary Beth Landrum & Mary Price & J. Michael McWilliams & John Hsu & Thomas McGuire, 2018. "The Comparative Advantage of Medicare Advantage," NBER Working Papers 24289, National Bureau of Economic Research, Inc.
    40. Alice Burns & Tamara Hayford, 2017. "Effects of Medicare Advantage Enrollment on Beneficiary Risk Scores: Working Paper 2017-08," Working Papers 53270, Congressional Budget Office.
    41. A. A. Withagen-Koster & R. C. Kleef & F. Eijkenaar, 2020. "Incorporating self-reported health measures in risk equalization through constrained regression," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(4), pages 513-528, June.
    42. Richard C. van Kleef & René C. J. A. van Vliet, 2022. "How to deal with persistently low/high spenders in health plan payment systems?," Health Economics, John Wiley & Sons, Ltd., vol. 31(5), pages 784-805, May.
    43. He, Qinghong & Liu, Gordon G. & Liu, Xiangbo & Tang, Daisheng, 2025. "Effects of separating drug sales from treatment on medical disputes," Social Science & Medicine, Elsevier, vol. 368(C).
    44. Thomas Goldring & Brian A. Jacob & Daniel Kreisman & Michael David Ricks, 2026. "Loopholes and the Incidence of Public Services: Evidence From Funding Career and Technical Education," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 45(1), January.
    45. Jeffrey P. Clemens & Jonathan M. Leganza & Alex Masucci, 2021. "Plugging Gaps in Payment Systems: Evidence from the Take-Up of New Medicare Billing Codes," CESifo Working Paper Series 9209, CESifo.
    46. Zhaowei She & Turgay Ayer & Daniel Montanera, 2022. "Can Big Data Cure Risk Selection in Healthcare Capitation Program? A Game Theoretical Analysis," Manufacturing & Service Operations Management, INFORMS, vol. 24(6), pages 3117-3134, November.
    47. Henriquez, Josefa & Fiorentini, Gianluca & Paolucci, Francesco, 2026. "Risk adjustment to improve fairness and efficiency of resource allocation: a case from the Emilia Romagna region in the decentralized Italian SSN," Social Science & Medicine, Elsevier, vol. 393(C).
    48. Momotazur Rahman & Brian McGarry & Elizabeth M. White & David C. Grabowski & Cyrus M. Kosar, 2025. "Is Managed Care Effective in Long-term Care Settings? Evidence from Medicare Institutional Special Needs Plans," NBER Working Papers 34235, National Bureau of Economic Research, Inc.
    49. Jason Abaluck & Jonathan Gruber, 2016. "Improving the Quality of Choices in Health Insurance Markets," NBER Working Papers 22917, National Bureau of Economic Research, Inc.
    50. Michael Geruso & Timothy J. Layton & Daniel Prinz, 2016. "Screening in Contract Design: Evidence from the ACA Health Insurance Exchanges," NBER Working Papers 22832, National Bureau of Economic Research, Inc.
    51. Daniel W. Sacks & Khoa Vu & Tsan-Yao Huang & Pinar Karaca-Mandic, 2017. "How do insurance firms respond to financial risk sharing regulations? Evidence from the Affordable Care Act," NBER Working Papers 24129, National Bureau of Economic Research, Inc.
    52. Delphine Roy, 2025. "Strategic Coding in the Assessment of Long‐Term Care Needs: Evidence From France," Health Economics, John Wiley & Sons, Ltd., vol. 34(6), pages 1035-1063, June.
    53. Ismail, I. & Stam, P.J.A. & Portrait, F.R.M. & van Witteloostuijn, A. & Koolman, X., 2024. "Addressing unanticipated interactions in risk equalization: A machine learning approach to modeling medical expenditure risk," Economic Modelling, Elsevier, vol. 130(C).
    54. Renuka M. Diwan & Paul J. Eliason & Riley League & Jetson Leder-Luis & Ryan C. McDevitt & James W. Roberts, 2026. "Competition and Fraud in Health Care," NBER Working Papers 34802, National Bureau of Economic Research, Inc.
    55. Francesco Decarolis & Andrea Guglielmo & Calvin Luscombe, 2017. "Open Enrollment Periods and Plan Choices," NBER Working Papers 24156, National Bureau of Economic Research, Inc.
    56. Kartik K. Ganju & Hilal Atasoy & Paul A. Pavlou, 2022. "Do Electronic Health Record Systems Increase Medicare Reimbursements? The Moderating Effect of the Recovery Audit Program," Management Science, INFORMS, vol. 68(4), pages 2889-2913, April.
    57. Daniel W. Sacks & Khoa Vu & Tsan‐Yao Huang & Pinar Karaca‐Mandic, 2021. "How do insurance firms respond to financial risk sharing regulations? Evidence from the Affordable Care Act," Health Economics, John Wiley & Sons, Ltd., vol. 30(6), pages 1443-1460, June.
    58. Richard van Kleef & Thomas McGuire & Rene van Vliet & Wynand van de Ven, 2015. "Improving Risk Equalization with Constrained Regression," NBER Working Papers 21570, National Bureau of Economic Research, Inc.
    59. Atul Gupta & Ambar La Forgia & Adam Sacarny, 2024. "Turbocharging Profits? Contract Gaming and Revenue Allocation in Healthcare," NBER Working Papers 32564, National Bureau of Economic Research, Inc.
    60. Brady Post & Edward C. Norton & Brent K. Hollenbeck & Andrew M. Ryan, 2022. "Hospital‐physician integration and risk‐coding intensity," Health Economics, John Wiley & Sons, Ltd., vol. 31(7), pages 1423-1437, July.
    61. Eijkenaar, Frank & van Vliet, René C.J.A., 2017. "Improving risk equalization for individuals with persistently high costs: Experiences from the Netherlands," Health Policy, Elsevier, vol. 121(11), pages 1169-1176.
    62. Daniel Montanera & Abhay Nath Mishra & T. S. Raghu, 2022. "Mitigating Risk Selection in Healthcare Entitlement Programs: A Beneficiary-Level Competitive Bidding Approach," Information Systems Research, INFORMS, vol. 33(4), pages 1221-1247, December.
    63. Lo, Charlene & Anselmi, Laura & Sutton, Matt, 2025. "Horizontal equity in primary care financing: An assessment of payments to general practices in England, 2014–2022," Social Science & Medicine, Elsevier, vol. 373(C).
    64. Bäuml, Matthias & Dette, Tilman & Pollmann, Michael, 2022. "Price and income effects of hospital reimbursements," Journal of Health Economics, Elsevier, vol. 81(C).

  19. Timothy J. Layton & Randall P. Ellis & Thomas G. McGuire, 2015. "Assessing Incentives for Adverse Selection in Health Plan Payment Systems," Boston University - Department of Economics - Working Papers Series wp2015-024, Boston University - Department of Economics.

    Cited by:

    1. Schmid, Christian P.R. & Beck, Konstantin, 2016. "Re-insurance in the Swiss health insurance market: Fit, power, and balance," Health Policy, Elsevier, vol. 120(7), pages 848-855.
    2. Richard C. Kleef & Thomas G. McGuire & René C. J. A. Vliet & Wynand P. P. M. de Ven, 2017. "Improving risk equalization with constrained regression," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(9), pages 1137-1156, December.
    3. Timothy Layton & Ellen J. Montz & Mark Shepard, 2017. "Health Plan Payment in U.S. Marketplaces: Regulated Competition with a Weak Mandate," NBER Working Papers 23444, National Bureau of Economic Research, Inc.
    4. Sungchul Park & Anirban Basu, 2018. "Alternative evaluation metrics for risk adjustment methods," Health Economics, John Wiley & Sons, Ltd., vol. 27(6), pages 984-1010, June.
    5. Layton, Timothy J. & McGuire, Thomas G. & van Kleef, Richard C., 2018. "Deriving risk adjustment payment weights to maximize efficiency of health insurance markets," Journal of Health Economics, Elsevier, vol. 61(C), pages 93-110.
    6. Benjamin R. Handel & Jonathan T. Kolstad, 2021. "The Affordable Care Act After a Decade: Industrial Organization of the Insurance Exchanges," NBER Working Papers 29178, National Bureau of Economic Research, Inc.
    7. Timothy J. Layton & Thomas G. McGuire, 2017. "Marketplace Plan Payment Options for Dealing with High-Cost Enrollees," American Journal of Health Economics, MIT Press, vol. 3(2), pages 165-191, Spring.
    8. Joseph P. Newhouse & Mary Beth Landrum & Mary Price & J. Michael McWilliams & John Hsu & Thomas McGuire, 2018. "The Comparative Advantage of Medicare Advantage," NBER Working Papers 24289, National Bureau of Economic Research, Inc.
    9. Julie Shi, 2017. "Efficiency in Plan Choice with Risk Adjustment and Risk-Based Pricing in Health Insurance Exchanges," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 42(1), pages 79-113, January.
    10. Henriquez, Josefa & Fiorentini, Gianluca & Paolucci, Francesco, 2026. "Risk adjustment to improve fairness and efficiency of resource allocation: a case from the Emilia Romagna region in the decentralized Italian SSN," Social Science & Medicine, Elsevier, vol. 393(C).
    11. Michael Geruso, 2016. "Demand Heterogeneity in Insurance Markets: Implications for Equity and Efficiency," NBER Working Papers 22440, National Bureau of Economic Research, Inc.
    12. Richard van Kleef & Thomas McGuire & Rene van Vliet & Wynand van de Ven, 2015. "Improving Risk Equalization with Constrained Regression," NBER Working Papers 21570, National Bureau of Economic Research, Inc.
    13. Shuli Brammli-Greenberg & Jacob Glazer & Ruth Waitzberg, 2019. "Modest risk-sharing significantly reduces health plans’ incentives for service distortion," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(9), pages 1359-1374, December.

  20. Randall P. Ellis & Timothy J. Layton, 2014. "Risk Selection and Risk Adjustment," Boston University - Department of Economics - Working Papers Series wp2014-011, Boston University - Department of Economics.

    Cited by:

    1. Pau Olivella, 2024. "Asymmetric information in health economics: Can contract regulation improve equity and efficiency?," Chapters, in: Daphne R. Raban & Julia WÅ‚odarczyk (ed.), The Elgar Companion to Information Economics, chapter 8, pages 154-169, Edward Elgar Publishing.
    2. Michael Geruso & Thomas G. McGuire, 2014. "Tradeoffs in the Design of Health Plan Payment Systems: Fit, Power and Balance," NBER Working Papers 20359, National Bureau of Economic Research, Inc.
    3. Liran Einav & Amy Finkelstein & Raymond Kluender & Paul Schrimpf, 2015. "Beyond Statistics: The Economic Content of Risk Scores," NBER Working Papers 21304, National Bureau of Economic Research, Inc.
    4. Jay Bhattacharya & Vilsa Curto & Liran Einav & Jonathan Levin, 2014. "Can Health Insurance Competition Work? Evidence from Medicare Advantage," Discussion Papers 14-015, Stanford Institute for Economic Policy Research.
    5. Benjamin R. Handel & Kate Ho, 2021. "Industrial Organization of Health Care Markets," NBER Working Papers 29137, National Bureau of Economic Research, Inc.
    6. Olivella, Pau & Vera-Hernández, Marcos, 2025. "Prioritisation, risk selection, and illness severity in a mixed healthcare system," Journal of Health Economics, Elsevier, vol. 104(C).
    7. Daniel Montanera & Abhay Nath Mishra & T. S. Raghu, 2022. "Mitigating Risk Selection in Healthcare Entitlement Programs: A Beneficiary-Level Competitive Bidding Approach," Information Systems Research, INFORMS, vol. 33(4), pages 1221-1247, December.

  21. Timothy J. Layton & Thomas G. McGuire & Anna D. Sinaiko, 2014. "Risk Corridors and Reinsurance in Health Insurance Marketplaces: Insurance for Insurers," NBER Working Papers 20515, National Bureau of Economic Research, Inc.

    Cited by:

    1. Schmid, Christian P.R. & Beck, Konstantin, 2016. "Re-insurance in the Swiss health insurance market: Fit, power, and balance," Health Policy, Elsevier, vol. 120(7), pages 848-855.
    2. Thomas G. McGuire & Sonja Schillo & Richard C. van Kleef, 2018. "Reinsurance, Repayments, and Risk Adjustment in Individual Health Insurance: Germany, The Netherlands and the U.S. Marketplaces," NBER Working Papers 25374, National Bureau of Economic Research, Inc.
    3. Lizhong Peng, 2017. "How Does Medicaid Expansion Affect Premiums in the Health Insurance Marketplaces? New Evidence from Late Adoption in Pennsylvania and Indiana," American Journal of Health Economics, MIT Press, vol. 3(4), pages 550-576, Fall.
    4. Timothy J. Layton & Randall P. Ellis & Thomas G. McGuire, 2015. "Assessing Incentives for Adverse Selection in Health Plan Payment Systems," NBER Working Papers 21531, National Bureau of Economic Research, Inc.
    5. Timothy Layton & Ellen J. Montz & Mark Shepard, 2017. "Health Plan Payment in U.S. Marketplaces: Regulated Competition with a Weak Mandate," NBER Working Papers 23444, National Bureau of Economic Research, Inc.
    6. Giampiero Marra & Rosalba Radice & David Zimmer, 2021. "Did the ACA's “guaranteed issue” provision cause adverse selection into nongroup insurance? Analysis using a copula‐based hurdle model," Health Economics, John Wiley & Sons, Ltd., vol. 30(9), pages 2246-2263, September.
    7. Michael Geruso & Timothy J. Layton & Grace McCormack & Mark Shepard, 2019. "The Two Margin Problem in Insurance Markets," NBER Working Papers 26288, National Bureau of Economic Research, Inc.
    8. Benjamin R. Handel & Jonathan T. Kolstad, 2021. "The Affordable Care Act After a Decade: Industrial Organization of the Insurance Exchanges," NBER Working Papers 29178, National Bureau of Economic Research, Inc.
    9. Timothy J. Layton & Thomas G. McGuire, 2017. "Marketplace Plan Payment Options for Dealing with High-Cost Enrollees," American Journal of Health Economics, MIT Press, vol. 3(2), pages 165-191, Spring.
    10. Pilny, Adam & Wübker, Ansgar & Ziebarth, Nicolas R., 2017. "Introducing Risk Adjustment and Free Health Plan Choice in Employer-Based Health Insurance: Evidence from Germany," IZA Discussion Papers 10870, IZA Network @ LISER.
    11. Daniel W. Sacks & Khoa Vu & Tsan-Yao Huang & Pinar Karaca-Mandic, 2017. "How do insurance firms respond to financial risk sharing regulations? Evidence from the Affordable Care Act," NBER Working Papers 24129, National Bureau of Economic Research, Inc.
    12. Michel Oskam & Richard C. van Kleef & Rudy Douven, 2024. "Heteroscedasticity of residual spending after risk equalization: a potential source of selection incentives in health insurance markets with premium regulation," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 25(3), pages 379-396, April.
    13. Daniel W. Sacks & Khoa Vu & Tsan‐Yao Huang & Pinar Karaca‐Mandic, 2021. "How do insurance firms respond to financial risk sharing regulations? Evidence from the Affordable Care Act," Health Economics, John Wiley & Sons, Ltd., vol. 30(6), pages 1443-1460, June.
    14. Richard C. Kleef & Mieke Reuser, 2021. "How the COVID-19 pandemic can distort risk adjustment of health plan payment," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(7), pages 1005-1016, September.

Articles

  1. Layton, Timothy J. & Politzer, Eran, 2025. "The dynamic fiscal costs of outsourcing health insurance - evidence from Medicaid," Journal of Public Economics, Elsevier, vol. 247(C).
    See citations under working paper version above.
  2. Kreider, Amanda R. & Layton, Timothy J. & Shepard, Mark & Wallace, Jacob, 2024. "Adverse selection and network design under regulated plan prices: Evidence from Medicaid," Journal of Health Economics, Elsevier, vol. 97(C).
    See citations under working paper version above.
  3. Michael Geruso & Timothy J. Layton & Grace McCormack & Mark Shepard, 2023. "The Two-Margin Problem in Insurance Markets," The Review of Economics and Statistics, MIT Press, vol. 105(2), pages 237-257, March.
    See citations under working paper version above.
  4. Zarek Brot-Goldberg & Timothy Layton & Boris Vabson & Adelina Yanyue Wang, 2023. "The Behavioral Foundations of Default Effects: Theory and Evidence from Medicare Part D," American Economic Review, American Economic Association, vol. 113(10), pages 2718-2758, October.
    See citations under working paper version above.
  5. Michael Geruso & Timothy J. Layton & Jacob Wallace, 2023. "What Difference Does a Health Plan Make? Evidence from Random Plan Assignment in Medicaid," American Economic Journal: Applied Economics, American Economic Association, vol. 15(3), pages 341-379, July.
    See citations under working paper version above.
  6. Timothy J. Layton & Nicole Maestas & Daniel Prinz & Boris Vabson, 2022. "Health Care Rationing in Public Insurance Programs: Evidence from Medicaid," American Economic Journal: Economic Policy, American Economic Association, vol. 14(4), pages 397-431, November.

    Cited by:

    1. Timothy Layton & Eran Politzer, 2024. "The Dynamic Fiscal Costs of Outsourcing Health Insurance - Evidence from Medicaid," NBER Working Papers 33302, National Bureau of Economic Research, Inc.
    2. Xinxin Chen & Jin Feng & Zhen Wang & Dandan Yu, 2026. "Insurance Coverage for Chronic Diseases and Healthcare of Low‐Income People: Evidence From Chinese Administrative Data," Health Economics, John Wiley & Sons, Ltd., vol. 35(2), pages 294-311, February.
    3. Marr, Jeffrey, 2025. "Algorithmic decision-making in health care: Evidence from post-acute care in Medicare Advantage," Journal of Health Economics, Elsevier, vol. 104(C).
    4. Lee, Ajin, 2025. "How does medicaid managed care affect provider behavior? New evidence from spillovers on private health care," Journal of Public Economics, Elsevier, vol. 248(C).

  7. Tal Gross & Timothy J. Layton & Daniel Prinz, 2022. "The Liquidity Sensitivity of Healthcare Consumption: Evidence from Social Security Payments," American Economic Review: Insights, American Economic Association, vol. 4(2), pages 175-190, June.
    See citations under working paper version above.
  8. Michael Geruso & Timothy Layton, 2020. "Upcoding: Evidence from Medicare on Squishy Risk Adjustment," Journal of Political Economy, University of Chicago Press, vol. 128(3), pages 984-1026.
    See citations under working paper version above.
  9. Bergquist, Savannah L. & Layton, Timothy J. & McGuire, Thomas G. & Rose, Sherri, 2019. "Data transformations to improve the performance of health plan payment methods," Journal of Health Economics, Elsevier, vol. 66(C), pages 195-207.

    Cited by:

    1. Thomas G. McGuire & Anna L. Zink & Sherri Rose, 2020. "Simplifying and Improving the Performance of Risk Adjustment Systems," NBER Working Papers 26736, National Bureau of Economic Research, Inc.
    2. Shuli Brammli-Greenberg & Sharvit Fialco & Neria Shtauber & Yoram Weiss, 2023. "Sex differences in care complexity and cost of cardiac-related procedures as a basis for improving hospital payments systems," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 24(4), pages 539-556, June.
    3. Henriquez, Josefa & Fiorentini, Gianluca & Paolucci, Francesco, 2026. "Risk adjustment to improve fairness and efficiency of resource allocation: a case from the Emilia Romagna region in the decentralized Italian SSN," Social Science & Medicine, Elsevier, vol. 393(C).
    4. Anna Zink & Sherri Rose, 2020. "Fair regression for health care spending," Biometrics, The International Biometric Society, vol. 76(3), pages 973-982, September.

  10. Michael Geruso & Timothy Layton & Daniel Prinz, 2019. "Screening in Contract Design: Evidence from the ACA Health Insurance Exchanges," American Economic Journal: Economic Policy, American Economic Association, vol. 11(2), pages 64-107, May.
    See citations under working paper version above.
  11. Layton, Timothy J. & McGuire, Thomas G. & van Kleef, Richard C., 2018. "Deriving risk adjustment payment weights to maximize efficiency of health insurance markets," Journal of Health Economics, Elsevier, vol. 61(C), pages 93-110.
    See citations under working paper version above.
  12. Timothy J. Layton & Thomas G. McGuire, 2017. "Marketplace Plan Payment Options for Dealing with High-Cost Enrollees," American Journal of Health Economics, MIT Press, vol. 3(2), pages 165-191, Spring.
    See citations under working paper version above.
  13. Michael Geruso & Timothy J. Layton, 2017. "Selection in Health Insurance Markets and Its Policy Remedies," Journal of Economic Perspectives, American Economic Association, vol. 31(4), pages 23-50, Fall.
    See citations under working paper version above.
  14. Layton, Timothy J., 2017. "Imperfect risk adjustment, risk preferences, and sorting in competitive health insurance markets," Journal of Health Economics, Elsevier, vol. 56(C), pages 259-280.

    Cited by:

    1. Mladenovic, Svetlana Sokolov & Milovancevic, Milos & Mladenovic, Igor & Petrovic, Jelena & Milovanovic, Dragan & Petković, Biljana & Resic, Sead & Barjaktarović, Miljana, 2020. "Identification of the important variables for prediction of individual medical costs billed by health insurance," Technology in Society, Elsevier, vol. 62(C).
    2. Carey, Colleen, 2021. "Sharing the burden of subsidization: Evidence on pass-through from a subsidy revision in Medicare Part D," Journal of Public Economics, Elsevier, vol. 198(C).
    3. Michele Fioretti & Hongming Wang, 2021. "Performance Pay in Insurance Markets: Evidence from Medicare," Post-Print hal-03791843, HAL.
    4. Antonini, Marcello & Henriquez, Josefa & van Kleef, Richard & Melia, Adrian & Paolucci, Francesco, 2026. "Can risk-rating of incremental premiums improve consumer sorting across coverage options in mandatory health insurance markets?," Journal of Economic Behavior & Organization, Elsevier, vol. 243(C).
    5. Colleen Carey, 2017. "Technological Change and Risk Adjustment: Benefit Design Incentives in Medicare Part D," American Economic Journal: Economic Policy, American Economic Association, vol. 9(1), pages 38-73, February.
    6. de Meza, David & Reito, Francesco & Reyniers, Diane, 2021. "Too much trade: The hidden problem of adverse selection," Journal of Public Economics, Elsevier, vol. 204(C).
    7. Timothy J. Layton & Randall P. Ellis & Thomas G. McGuire, 2015. "Assessing Incentives for Adverse Selection in Health Plan Payment Systems," NBER Working Papers 21531, National Bureau of Economic Research, Inc.
    8. Michael Geruso & Timothy Layton, 2017. "Selection in Health Insurance Markets and Its Policy Remedies," NBER Working Papers 23876, National Bureau of Economic Research, Inc.
    9. Aline de Souza & Mônica Viegas Andrade & Kenya Valéria Micaela de Souza Noronha & Igor Viveiros Melo Souza, 2025. "Effect of age‐related premium readjustment on health insurance cancellation in Brazil: Regression discontinuity approach," Health Economics, John Wiley & Sons, Ltd., vol. 34(1), pages 3-17, January.
    10. Anders Anell & Margareta Dackehag & Jens Dietrichson & Lina Maria Ellegård & Gustav Kjellsson, 2025. "Better off by risk adjustment? Socioeconomic disparities in care utilization in Sweden following a payment reform," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 44(3), pages 836-868, June.
    11. Timothy J. Layton & Thomas G. McGuire & Anna D. Sinaiko, 2014. "Risk Corridors and Reinsurance in Health Insurance Marketplaces: Insurance for Insurers," NBER Working Papers 20515, National Bureau of Economic Research, Inc.
    12. Liran Einav & Amy Finkelstein, 2023. "Empirical analyses of selection and welfare in insurance markets: a self-indulgent survey," The Geneva Risk and Insurance Review, Palgrave Macmillan;International Association for the Study of Insurance Economics (The Geneva Association), vol. 48(2), pages 167-191, September.
    13. Tomas Pedro Sanguinetti, 2019. "How Do Couples Choose Individual Insurance Plans? Evidence from Medicare Part D," 2019 Papers psa1760, Job Market Papers.
    14. Evan Saltzman, 2021. "Managing adverse selection: underinsurance versus underenrollment," RAND Journal of Economics, RAND Corporation, vol. 52(2), pages 359-381, June.
    15. Michael Geruso, 2016. "Demand Heterogeneity in Insurance Markets: Implications for Equity and Efficiency," NBER Working Papers 22440, National Bureau of Economic Research, Inc.

  15. Layton, Timothy J. & Ellis, Randall P. & McGuire, Thomas G. & van Kleef, Richard, 2017. "Measuring efficiency of health plan payment systems in managed competition health insurance markets," Journal of Health Economics, Elsevier, vol. 56(C), pages 237-255.

    Cited by:

    1. Thomas G. McGuire & Sonja Schillo & Richard C. van Kleef, 2018. "Reinsurance, Repayments, and Risk Adjustment in Individual Health Insurance: Germany, The Netherlands and the U.S. Marketplaces," NBER Working Papers 25374, National Bureau of Economic Research, Inc.
    2. de Meza, David & Reito, Francesco & Reyniers, Diane, 2021. "Too much trade: The hidden problem of adverse selection," Journal of Public Economics, Elsevier, vol. 204(C).
    3. Wynand P. M. M. Ven & Richard C. Kleef, 2025. "A critical review of the use of R2 in risk equalization research," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 26(3), pages 363-375, April.
    4. Douven, Rudy & Kauer, Lukas, 2023. "Falling ill raises the health insurer's administration bill," Social Science & Medicine, Elsevier, vol. 324(C).
    5. Timothy Layton & Ellen J. Montz & Mark Shepard, 2017. "Health Plan Payment in U.S. Marketplaces: Regulated Competition with a Weak Mandate," NBER Working Papers 23444, National Bureau of Economic Research, Inc.
    6. Timothy Layton & Alice K. Ndikumana & Mark Shepard, 2017. "Health Plan Payment in Medicaid Managed Care: A Hybrid Model of Regulated Competition," NBER Working Papers 23518, National Bureau of Economic Research, Inc.
    7. Michael Geruso & Timothy J. Layton & Grace McCormack & Mark Shepard, 2019. "The Two Margin Problem in Insurance Markets," NBER Working Papers 26288, National Bureau of Economic Research, Inc.
    8. Wang, Xuanhe & Wu, Huiyan & Meng, Shengwang & Liu, Kui & Chen, Hanyi, 2025. "Deregulation, claims ratio, and consumer surplus: Evidence from China's auto insurance reform," Pacific-Basin Finance Journal, Elsevier, vol. 94(C).
    9. Constantinou, Panayotis & Tuppin, Philippe & Gastaldi-Ménager, Christelle & Pelletier-Fleury, Nathalie, 2022. "Defining a risk-adjustment formula for the introduction of population-based payments for primary care in France," Health Policy, Elsevier, vol. 126(9), pages 915-924.
    10. Thomas G. McGuire & Anna L. Zink & Sherri Rose, 2020. "Simplifying and Improving the Performance of Risk Adjustment Systems," NBER Working Papers 26736, National Bureau of Economic Research, Inc.
    11. Liran Einav & Amy Finkelstein, 2023. "Empirical analyses of selection and welfare in insurance markets: a self-indulgent survey," The Geneva Risk and Insurance Review, Palgrave Macmillan;International Association for the Study of Insurance Economics (The Geneva Association), vol. 48(2), pages 167-191, September.
    12. Peter Paul Klein & Richard van Kleef & Josefa Henriquez & Francesco Paolucci, 2023. "The interplay between risk adjustment and risk rating in voluntary health insurance," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 90(1), pages 59-91, March.
    13. A. A. Withagen-Koster & R. C. Kleef & F. Eijkenaar, 2020. "Incorporating self-reported health measures in risk equalization through constrained regression," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(4), pages 513-528, June.
    14. Richard C. van Kleef & René C. J. A. van Vliet, 2022. "How to deal with persistently low/high spenders in health plan payment systems?," Health Economics, John Wiley & Sons, Ltd., vol. 31(5), pages 784-805, May.
    15. Kauer, Lukas & McGuire, Thomas G. & Beck, Konstantin, 2020. "Extreme under and overcompensation in morbidity-based health plan payments: The case of Switzerland," Health Policy, Elsevier, vol. 124(1), pages 61-68.
    16. Thomas G. McGuire & Sonja Schillo & Richard C. Kleef, 2021. "Very high and low residual spenders in private health insurance markets: Germany, The Netherlands and the U.S. Marketplaces," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(1), pages 35-50, February.
    17. Ismail, I. & Stam, P.J.A. & Portrait, F.R.M. & van Witteloostuijn, A. & Koolman, X., 2024. "Addressing unanticipated interactions in risk equalization: A machine learning approach to modeling medical expenditure risk," Economic Modelling, Elsevier, vol. 130(C).
    18. Savannah L. Bergquist & Timothy J. Layton & Thomas G. McGuire & Sherri Rose, 2018. "Intervening on the Data to Improve the Performance of Health Plan Payment Methods," NBER Working Papers 24491, National Bureau of Economic Research, Inc.
    19. Anna Zink & Sherri Rose, 2020. "Fair regression for health care spending," Biometrics, The International Biometric Society, vol. 76(3), pages 973-982, September.
    20. Shuli Brammli-Greenberg & Jacob Glazer & Ruth Waitzberg, 2019. "Modest risk-sharing significantly reduces health plans’ incentives for service distortion," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(9), pages 1359-1374, December.

  16. Timothy J. Layton & Thomas G. McGuire & Anna D. Sinaiko, 2016. "Risk Corridors and Reinsurance in Health Insurance Marketplaces: Insurance for Insurers," American Journal of Health Economics, MIT Press, vol. 2(1), pages 66-95, Winter.
    See citations under working paper version above.
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