Medicare Secondary Payer and Settlement Delay

June 7, 2018

The Medicare Secondary Payer Act of 1980 and its subsequent amendments require that insurers and self‐insured companies report settlements, awards, and judgments that involve a Medicare beneficiary to the Centers for Medicare and Medicaid Services. The parties then may be required to compensate CMS for its conditional payments. In a simple settlement model, this makes settlement less likely. Also, the reporting delays and uncertainty regarding the size of these conditional payments are likely to further frustrate the settlement process. We provide results, using data from a large insurer, showing that, on average, implementation of the MSP reporting amendments led to a delay in the resolution of disputes involving auto accidents of about six months.

via Medicare Secondary Payer and Settlement Delay by Eric Helland, Jonathan Klick :: SSRN


Declining Teen Employment: Minimum Wages, Other Explanations, and Implications for Human Capital Investment

May 29, 2018

We explore the decline in teen employment in the United States since 2000, which was sharpest for those age 16–17. We consider three explanatory factors: a rising minimum wage that could reduce employment opportunities for teens and potentially increase the value of investing in schooling; rising returns to schooling; and increasing competition from immigrants that, like the minimum wage, could reduce employment opportunities and raise the returns to human capital investment. We find that higher minimum wages are the predominant factor explaining changes in the schooling and workforce behavior of those age 16–17 since 2000. We also consider implications for human capital. Higher minimum wages have led both to fewer teens in school and employed at the same time, and to more teens in school but not employed, which is potentially consistent with a greater focus on schooling. We find no evidence that higher minimum wages have led to greater human capital investment. If anything, the evidence points to adverse effects on longer-run earnings for those exposed to these higher minimum wages as teenagers.

via Declining Teen Employment: Minimum Wages, Other Explanations, and Implications for Human Capital Investment by David Neumark, Cortnie Shupe :: SSRN


Household Bundling to Reduce Adverse Selection: Application to Social Health Insurance

May 17, 2018

This paper explores the use of bundling to reduce adverse selection in insurance mar-kets and its application to social health insurance programs. When the choice to buy health insurance is made at the household level, bundling the insurance policies of household mem-bers eliminates the effect of adverse selection within a household since the household can no longer select only sick members to enroll. However, this can exacerbate adverse selection across households, as healthier households might choose to drop out of the insurance market. The net effect of this trade-off depends on the characteristics of the household demand for medical care and risk preferences. I explore this issue using individual survey data on insur-ance enrollment and medical spending in Vietnam that contain detailed information about the structure of the household. The reduced-form evidence suggests that income, own-price and cross-member substitution effects play important roles in the demand for medical care, which affects a household’s selection of members into insurance. I then develop and estimate a model of household insurance bundle choice and medical utilization that accounts for these features. The results suggest that much of the adverse selection is concentrated within the household. Counterfactual analysis reveals that under optimal pricing, household bundling yields significantly higher consumer surplus and insurance enrollment than individual pur-chase. Furthermore, the insurance market is less susceptible to complete unraveling under household bundling.

via Household Bundling to Reduce Adverse Selection: Application to Social Health Insurance by Anh Nguyen :: SSRN


Medicare Secondary Payer and Settlement Delay

May 13, 2018

The Medicare Secondary Payer Act of 1980 and its subsequent amendments require that insurers and self‐insured companies report settlements, awards, and judgments that involve a Medicare beneficiary to the Centers for Medicare and Medicaid Services. The parties then may be required to compensate CMS for its conditional payments. In a simple settlement model, this makes settlement less likely. Also, the reporting delays and uncertainty regarding the size of these conditional payments are likely to further frustrate the settlement process. We provide results, using data from a large insurer, showing that, on average, implementation of the MSP reporting amendments led to a delay in the resolution of disputes involving auto accidents of about six months.

via Medicare Secondary Payer and Settlement Delay by Eric Helland, Jonathan Klick :: SSRN


Privacy Remedies

May 8, 2018

When consumers sue companies for privacy-intrusive practices they are often unsuccessful. Many cases fail in federal court at the motion to dismiss phase because the plaintiff has not shown the privacy infringement has caused her concrete harm. This is a symptom of a broader issue: the failure of courts and commentators to describe the relationship between privacy rights and privacy remedies.

This Article contends that restitution is the normal measure of privacy remedies. Restitution measures relief by economic gain to defendant. If a plaintiff can show the likely ability to recover in restitution, that should be sufficient to pass muster at the motion to dismiss phase even if the court is unconvinced that the plaintiff could show a case for compensatory damages flowing from harm.

This argument intervenes in the scholarly literature in two ways. First, it supports the realist perspective that remedies are constitutive of rights. The election of restitution as a remedy suggests that privacy should be conceptualized in tort as quasi-property, and that contract and/or restitution claims should be a standard part of privacy infringement pleadings. Second, it challenges the view that defining specific and stronger privacy rights at law would be sufficient to increase privacy protection. If any privacy rights are to exist at all, they must be linked to proportional, accessible remedies.

via Privacy Remedies by Lauren Henry Scholz :: SSRN


Minimum Wage Analysis Using a Pre-Committed Research Design: Evidence Through 2016

May 5, 2018

This paper presents results from the first year of a multi-year, pre-committed research design for analyzing recent state-level minimum wage changes. Through 2015 and 2016, we estimate that relatively large statutory minimum wage increases have reduced employment among low-skilled population groups by just under 1.5 percentage points. Our estimates of the effects of smaller minimum wage increases are more variable and include both moderately large positive values and modest negative values.Our estimates of the effects of increases linked to inflation-indexing provisions are also quite variable, taking a small positive value on average across specifications. Results including 2016 diverge nontrivially when we compare estimates using the American Community Survey (ACS) to estimates using the Current Population Survey (CPS), with estimates tending to be more negative in the ACS. Analysis of future data will be needed to determine whether this difference across surveys is most appropriately attributed to sampling variations or to some other cause.

via Minimum Wage Analysis Using a Pre-Committed Research Design: Evidence Through 2016 by Jeffrey P. Clemens, Michael Strain :: SSRN


Ideology Meets Reality: What Works and What Doesn’t in Patient Exposure to Health Care Costs

February 14, 2018

U.S. policymakers, scholars, and advocates have long displayed an ideological commitment to exposing insured patients to substantial out-of-pocket expenses. These commitments derive from both overt political ideologies, which favor individual responsibility and oppose redistribution of wealth and risks, as well as more-subtle ideological commitments of academic economists, which link observed patterns of consumption to value-claims about welfare. In this symposium contribution, we document those ideological commitments and juxtapose them with a review of the scientific evidence about the actual effects of patient cost-sharing. We find, as economic theory predicts, that patients exposed to healthcare costs consume less healthcare. However, a fair review of the evidence — including the effects on health outcomes, access to care, and financial insecurity — makes it very hard to conclude that substantial and untailored cost-sharing exposure — as we have seen in actual application — is good social policy. We suggest directions for future study and reform.

via Ideology Meets Reality: What Works and What Doesn’t in Patient Exposure to Health Care Costs by Victor Laurion, Christopher T. Robertson :: SSRN