Inferring Risk Perceptions and Preferences using Choice from Insurance Menus: Theory and Evidence

Inferring Risk Perceptions and Preferences using Choice from Insurance Menus: Theory and Evidence

New working paper:

Inferring Risk Perceptions and Preferences using Choice from Insurance Menus: Theory and Evidence (joint with Philipp Kircher, Johannes Spinnewijn, and Amanda Starc)

Demand for insurance can be driven by high risk aversion or high risk. We show how to separately identify risk preferences and risk types using only choices from menus of insurance plans. Our revealed preference approach does not rely on rational expectations, nor does it require access to claims data. We show what can be learned non-parametrically from variation in insurance plans, offered separately to random cross-sections or offered as part of the same menu to one cross-section. We prove that our approach allows for full identification in the textbook model with binary risks and extend our results to continuous risks. We illustrate our approach using the Massachusetts Health Insurance Exchange, where choices provide informative bounds on the type distributions, especially for risks, but do not allow us to reject homogeneity in preferences.

Measuring Consumer Valuation of Limited Provider Networks

Measuring Consumer Valuation of Limited Provider Networks

Measuring Consumer Valuation of Limited Provider Networks

Published: American Economic Review, Papers and Proceedings, 2015.

Longer version: NBER Working Paper 20812. (Joint with Amanda Starc)

WTP for Network Breadth

We measure provider coverage networks for plans on the Massachusetts health insurance exchange using a two measures: consumer surplus from a hospital demand system and the fraction of population hospital admissions that would be covered by the network. The two measures are highly correlated, and show a wide range of networks available to consumers. We then estimate consumer willingness-to-pay for network breadth, which varies by age. 60-year-olds value the broadest network approximately $1200-1400/year more than the narrowest network, while 30-year-olds value it about half as much. Consumers place additional value on star hospitals, and there is significant geographic heterogeneity in the value of network breadth.

Measuring Consumer Valuation of Limited Provider Networks

Measuring Consumer Valuation of Limited Provider Networks

Published: American Economic Review, Papers and Proceedings, 2015.

Longer version: NBER Working Paper 20812. (Joint with Amanda Starc)

WTP for Network Breadth

 

We measure provider coverage networks for plans on the Massachusetts health insurance exchange using a two measures: consumer surplus from a hospital demand system and the fraction of population hospital admissions that would be covered by the network. The two measures are highly correlated, and show a wide range of networks available to consumers. We then estimate consumer willingness-to-pay for network breadth, which varies by age. 60-year-olds value the broadest network approximately $1200-1400/year more than the narrowest network, while 30-year-olds value it about half as much. Consumers place additional value on star hospitals, and there is significant geographic heterogeneity in the value of network breadth.

How Product Standardization Affects Choice: Evidence from the Massachusetts Health Insurance Exchange

Product Standardization on the Mass. HIX

Product Standardization on the Mass. HIX

Standardization of complex products is touted as improving consumer decisions and intensifying price competition, but evidence on standardization is limited. We examine a natural experiment: the standardization of health insurance plans on the Massachusetts Health Insurance Exchange.

Pre-standardization, firms had wide latitude to design plans. A regulatory change then required firms to standardize the cost-sharing parameters of plans and offer seven defined options; plans remained differentiated on network, brand, and price. Standardization led consumers on the HIX to choose more generous health insurance plans and led to substantial shifts in brands’ market shares.

We decompose the sources of this shift into three effects: price, product availability, and valuation. A discrete choice model shows that standardization changed the weights consumers attach to plan attributes (a valuation effect), increasing the salience of tier. The availability effect explains the bulk of the brand shifts. Standardization increased consumer welfare in our models, but firms captured some of the surplus by reoptimizing premiums. We use hypothetical choice experiments to replicate the effect of standardization and conduct alternative counterfactuals.

Link to Full Working Paper: How Product Standardization Affects Choice: Evidence from the Massachusetts Health Insurance Exchange

 

How Product Standardization Affects Choice: Evidence from the Massachusetts Health Insurance Exchange

How Product Standardization Affects Choice: Evidence from the Massachusetts Health Insurance Exchange

Product Standardization on the Mass. HIX

Product Standardization on the Mass. HIX

Standardization of complex products is touted as improving consumer decisions and intensifying price competition, but evidence on standardization is limited. We examine a natural experiment: the standardization of health insurance plans on the Massachusetts Health Insurance Exchange.

Link to Full Working Paper: How Product Standardization Affects Choice: Evidence from the Massachusetts Health Insurance Exchange

Pre-standardization, firms had wide latitude to design plans. A regulatory change then required firms to standardize the cost-sharing parameters of plans and offer seven defined options; plans remained differentiated on network, brand, and price. Standardization led consumers on the HIX to choose more generous health insurance plans and led to substantial shifts in brands’ market shares.

We decompose the sources of this shift into three effects: price, product availability, and valuation. A discrete choice model shows that standardization changed the weights consumers attach to plan attributes (a valuation effect), increasing the salience of tier. The availability effect explains the bulk of the brand shifts. Standardization increased consumer welfare in our models, but firms captured some of the surplus by reoptimizing premiums. We use hypothetical choice experiments to replicate the effect of standardization and conduct alternative counterfactuals.

Invest-then-Harvest Pricing in Medicare Part D

Invest-then-Harvest Pricing in Medicare Part D

Individuals face switching frictions in many products, and insurance exchanges are no exception. In a paper published in the American Economic Journal: Economic Policy, I show that initial defaults have lasting effects in the Medicare Part D prescription drug insurance exchange. Since firms cannot commit to future prices, they should respond to inertia by raising prices on existing enrollees, while introducing cheaper alternative plans. I show that the market displays this pattern: older plans in this market are about 10% more expensive than comparable newly introduced plans.

For more:

Pricing Regulation and Imperfect Competition on the Massachusetts Health Insurance Exchange

Pricing Regulation and Imperfect Competition on the Massachusetts Health Insurance Exchange

Review of Economics and Statistics, 2015. (joint with Amanda Starc)Also see NBER Working Paper 18089.

Insurance markets often contain pricing regulation, such as community rating. I examine how pricing regulation interacts with imperfect competition.

When markets are imperfectly competitive,  these regulations link prices for consumers that differ not only in costs, but also in preferences.  Tightening community rating regulation doesn’t merely move the price toward the average cost, since firms price to the marginal enrollee. As a result, community rating regulation can affect firm profits and market efficiency. We look at the Massachusetts Health Insurance Exchange (HIX), and show that younger individuals are much more price sensitive than older individuals.  Thus, insurers should charge higher markups on older individuals. Tighter community rating restrictions transfer money from younger consumers to older consumers, but also from firm profits to consumer surplus.