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Use of Shared and Private Information in Long-Term Care Risk Perceptions

Author

Listed:
  • Lisa Voois

    (Erasmus University Rotterdam)

  • Teresa Bago d-Uva

    (Erasmus University Rotterdam)

  • Owen O'Donnell

    (Erasmus University Rotterdam)

Abstract

Misperception of long-term care (LTC) risk may distort insurance and saving decisions. Comparing older Americans’ subjective probabilities of nursing home entry with realized outcomes, we find LTC risk perceptions are inaccurate, partly due to inappropriate weighting of risk factors insurers can observe. Risk perceptions capture only 37% of the potential discriminatory power of this shared information. Private information offsets only one third of the resulting inaccuracy. LTC insurance take-up is positively associated with perceived risk even after adjusting for confounders and reverse causality. These findings are consistent with selection out of insurance partly due to underutilization of shared information.

Suggested Citation

  • Lisa Voois & Teresa Bago d-Uva & Owen O'Donnell, 2026. "Use of Shared and Private Information in Long-Term Care Risk Perceptions," Tinbergen Institute Discussion Papers 26-013/V, Tinbergen Institute.
  • Handle: RePEc:tin:wpaper:20260013
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    References listed on IDEAS

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    1. Kate Ho & Joseph Hogan & Fiona Scott Morton, 2017. "The impact of consumer inattention on insurer pricing in the Medicare Part D program," RAND Journal of Economics, RAND Corporation, vol. 48(4), pages 877-905, December.
    2. Joshua Schwartzstein, 2014. "Selective Attention And Learning," Journal of the European Economic Association, European Economic Association, vol. 12(6), pages 1423-1452, December.
    3. Arthur Lewbel, 2012. "Using Heteroscedasticity to Identify and Estimate Mismeasured and Endogenous Regressor Models," Journal of Business & Economic Statistics, Taylor & Francis Journals, vol. 30(1), pages 67-80.
    4. Johannes Spinnewijn, 2017. "Heterogeneity, Demand for Insurance, and Adverse Selection," American Economic Journal: Economic Policy, American Economic Association, vol. 9(1), pages 308-343, February.
    5. Delavande, Adeline & Del Bono, Emilia & Holford, Angus, 2025. "Imprecise health beliefs and health behavior," Journal of Health Economics, Elsevier, vol. 102(C).
    6. Nathaniel Hendren, 2013. "Private Information and Insurance Rejections," Econometrica, Econometric Society, vol. 81(5), pages 1713-1762, September.
    7. Emily Oster, 2019. "Unobservable Selection and Coefficient Stability: Theory and Evidence," Journal of Business & Economic Statistics, Taylor & Francis Journals, vol. 37(2), pages 187-204, April.
    8. Pedro Bordalo & Nicola Gennaioli & Andrei Shleifer, 2012. "Salience Theory of Choice Under Risk," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 127(3), pages 1243-1285.
    9. William F. Bassett & Robin L. Lumsdaine, 2001. "Probability Limits: Are Subjective Assessments Adequately Accurate?," Journal of Human Resources, University of Wisconsin Press, vol. 36(2), pages 327-363.
    10. De Donder Philippe & Leroux Marie-Louise, 2013. "Behavioral Biases and Long-Term Care Insurance: A Political Economy Approach," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 14(2), pages 551-575, May.
    11. Kristin J. Kleinjans & Arthur Van Soest, 2014. "Rounding, Focal Point Answers And Nonresponse To Subjective Probability Questions," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 29(4), pages 567-585, June.
    12. Pamela Giustinelli & Charles F Manski & Francesca Molinari, 2022. "Precise or Imprecise Probabilities? Evidence from Survey Response Related to Late-Onset Dementia," Journal of the European Economic Association, European Economic Association, vol. 20(1), pages 187-221.
    13. Jeffrey R. Brown & Amy Finkelstein, 2009. "The Private Market for Long‐Term Care Insurance in the United States: A Review of the Evidence," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 76(1), pages 5-29, March.
    14. Adam Solomon, 2026. "Imperfect Private Information in Insurance Markets," The Review of Economics and Statistics, MIT Press, vol. 108(2), pages 485-503, March.
    15. José Luis Montiel Olea & Carolin Pflueger, 2013. "A Robust Test for Weak Instruments," Journal of Business & Economic Statistics, Taylor & Francis Journals, vol. 31(3), pages 358-369, July.
    16. Jonathan D. Ketcham & Claudio Lucarelli & Christopher A. Powers, 2015. "Paying Attention or Paying Too Much in Medicare Part D," American Economic Review, American Economic Association, vol. 105(1), pages 204-233, January.
    17. Benjamin Handel & Jonathan Kolstad & Thomas Minten & Johannes Spinnewijn, 2024. "The Socioeconomic Distribution of Choice Quality: Evidence from Health Insurance in the Netherlands," American Economic Review: Insights, American Economic Association, vol. 6(3), pages 395-412, September.
    18. Drerup, Tilman & Enke, Benjamin & von Gaudecker, Hans-Martin, 2017. "The precision of subjective data and the explanatory power of economic models," Journal of Econometrics, Elsevier, vol. 200(2), pages 378-389.
    19. M. Martin Boyer & Philippe De Donder & Claude Fluet & Marie-Louise Leroux & Pierre-Carl Michaud, 2020. "Long-Term Care Insurance: Information Frictions and Selection," American Economic Journal: Economic Policy, American Economic Association, vol. 12(3), pages 134-169, August.
    20. Handel, Benjamin R. & Kolstad, Jonathan T. & Minten, Thomas & Spinnewijn, Johannes, 2024. "The socioeconomic distribution of choice quality: evidence from health insurance in the Netherlands," LSE Research Online Documents on Economics 121132, London School of Economics and Political Science, LSE Library.
    21. Nicola Gennaioli & Andrei Shleifer, 2010. "What Comes to Mind," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 125(4), pages 1399-1433.
    22. Aurélien Baillon & Aleli Kraft & Owen O’Donnell & Kim Wilgenburg, 2022. "A behavioral decomposition of willingness to pay for health insurance," Journal of Risk and Uncertainty, Springer, vol. 64(1), pages 43-87, February.
    23. John Ameriks & Joseph Briggs & Andrew Caplin & Matthew D. Shapiro & Christopher Tonetti, 2020. "Long-Term-Care Utility and Late-in-Life Saving," Journal of Political Economy, University of Chicago Press, vol. 128(6), pages 2375-2451.
    24. Benjamin R. Handel & Jonathan T. Kolstad & Johannes Spinnewijn, 2019. "Information Frictions and Adverse Selection: Policy Interventions in Health Insurance Markets," The Review of Economics and Statistics, MIT Press, vol. 101(2), pages 326-340, May.
    25. Jason Abaluck & Jonathan Gruber, 2016. "Evolving Choice Inconsistencies in Choice of Prescription Drug Insurance," American Economic Review, American Economic Association, vol. 106(8), pages 2145-2184, August.
    26. Saurabh Bhargava & George Loewenstein & Justin Sydnor, 2017. "Choose to Lose: Health Plan Choices from a Menu with Dominated Option," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 132(3), pages 1319-1372.
    27. Benjamin R. Handel, 2013. "Adverse Selection and Inertia in Health Insurance Markets: When Nudging Hurts," American Economic Review, American Economic Association, vol. 103(7), pages 2643-2682, December.
    28. Jeffrey R. Brown & Amy Finkelstein, 2011. "Insuring Long-Term Care in the United States," Journal of Economic Perspectives, American Economic Association, vol. 25(4), pages 119-142, Fall.
    29. de Meza, David & Webb, David C, 2001. "Advantageous Selection in Insurance Markets," RAND Journal of Economics, The RAND Corporation, vol. 32(2), pages 249-262, Summer.
    30. Katherine Baicker & Sendhil Mullainathan & Joshua Schwartzstein, 2015. "Behavioral Hazard in Health Insurance," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 130(4), pages 1623-1667.
    31. Amy Finkelstein & Kathleen McGarry, 2006. "Multiple Dimensions of Private Information: Evidence from the Long-Term Care Insurance Market," American Economic Review, American Economic Association, vol. 96(4), pages 938-958, September.
    32. Giustinelli, Pamela & Manski, Charles F. & Molinari, Francesca, 2022. "Tail and center rounding of probabilistic expectations in the Health and Retirement Study," Journal of Econometrics, Elsevier, vol. 231(1), pages 265-281.
    33. Lambregts, Timo R. & Schut, Frederik T., 2020. "Displaced, disliked and misunderstood: A systematic review of the reasons for low uptake of long-term care insurance and life annuities," The Journal of the Economics of Ageing, Elsevier, vol. 17(C).
    34. Manski, Charles F. & Molinari, Francesca, 2010. "Rounding Probabilistic Expectations in Surveys," Journal of Business & Economic Statistics, American Statistical Association, vol. 28(2), pages 219-231.
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    Keywords

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    JEL classification:

    • D82 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Asymmetric and Private Information; Mechanism Design
    • D83 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Search; Learning; Information and Knowledge; Communication; Belief; Unawareness
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private

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