The response to dynamic incentives in insurance contracts with a deductible: Evidence from a differences-in-regression-discontinuities design

• 成果类型: Article
• 署名作者: Klein, Tobias J.; Salm, Martin; Upadhyay, Suraj
• 署名单位: Tilburg University
• 刊物名称: JOURNAL OF PUBLIC ECONOMICS
• ISSN/ISSBN: 0047-2727
• DOI: 10.1016/j.jpubeco.2022.104660
• 发表日期: 2022
• 关键词: Patient cost-sharing; health insurance; Dynamic incentives

摘要

We develop a new approach to quantify how patients respond to dynamic incentives in health insurance contracts with a deductible. Our approach exploits two sources of variation in a differences-in-regres sion-discontinuities design: deductible contracts reset at the beginning of the year, and cost-sharing limits change over the years. Using rich claims-level data from a large Dutch health insurer we find that individuals are forward-looking. Changing dynamic incentives by increasing the deductible by euro100 leads to a reduction in healthcare spending of around 3% on the first days of the year and 6% at the annual level. We find that the response to dynamic incentives is an important part of the overall effect of cost-sharing schemes on healthcare expenditures-much more so than what the previous literature has suggested. (c) 2022 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).