Do health plans risk-select? An audit study on Germany's Social Health Insurance

• 成果类型: Article
• 署名作者: Bauhoff, Sebastian
• 署名单位: RAND Corporation
• 刊物名称: JOURNAL OF PUBLIC ECONOMICS
• ISSN/ISSBN: 0047-2727
• DOI: 10.1016/j.jpubeco.2012.05.011
• 发表日期: 2012
• 页码: 750-759
• 关键词: Health insurance; Risk selection; risk adjustment; Geographic variations; Germany

摘要

This paper evaluates whether health plans in Germany's Social Health Insurance select on an easily observable predictor of risk: geography. To identify plan behavior separately from concurrent demand-side adverse selection, I implement a double-blind audit study in which plans are contacted by fictitious applicants from different locations. I find that plans are less likely to respond and follow-up with applicants from higher-cost regions, such as West Germany. The results suggest that supply-side selection may emerge even in heavily regulated insurance markets. The prospect of risk selection by firms has implications for studies of demand-side selection and regulatory policy in these settings. (C) 2012 Elsevier B.V. All rights reserved.