Essays on Health Economics

TitleEssays on Health Economics
Publication TypeThesis
Year of Publication2015
AuthorsIppolito, BN
AdvisorScholz, JKarl
Number of Pages95
Date Published2015
UniversityThe University of Wisconsin - Madison
CityMadison, WI
Thesis TypePh.D.
Accession Number1700219263
KeywordsEmployment and Labor Force, Healthcare, Income, Insurance, Methodology, Net Worth and Assets, Retirement Planning and Satisfaction

The first chapter, co-authored with Michael Batty, investigates how financial constraints influence hospital care. Specifically we study the impacts of recently enacted state "Fair Pricing" laws, which explicitly limit how much hospitals can collect from uninsured patients. Using the Nationwide Inpatient Sample, we find that the introduction of a fair pricing law leads to reductions in the amount of care delivered to uninsured patients, but find no evidence of deterioration of short-term quality of care. Overall, our results provide strong evidence that hospitals actively alter their behavior in response to financial incentives, and are consistent with the laws promoting a shift towards more efficient care delivery. In the second chapter I investigate how retirement incentives embedded in health insurance contracts influence labor market decisions of older workers. Employers typically offer one of two types of health plans: tied contracts (coverage ends at retirement) or retiree contracts (coverage continues in retirement). In comparison to a retiree plan, a tied contract provides an obvious incentive to delay retirement, but which workers stay? Particularly, what are the health characteristics of workers who respond to the incentives of the tied contract? I show that, contrary to suggestions in the literature, tied contracts produce advantageous selection. Additionally, I investigate the fact that tied contracts are consistently found to delay retirement even after age 65 - at which point workers are eligible for Medicare coverage. I show that this "excess retention" effect is entirely driven by workers with younger spouses who do not have their own insurance. The final chapter is joint work with Michael Batty and Joseph Levy, and examines how physician behavior responds to the introduction of a "panel-based" compensation structure - where a large portion of compensation is based on the number of patients a provider is responsible for, rather than the amount of work actually done. Taking advantage of a natural experiment at a large academic health system, we show that physician behavior is surprisingly unresponsive to changes in incentives - particularly for those who experienced a clear reduction in production incentives.


Copyright - Copyright ProQuest, UMI Dissertations Publishing 2015 Last updated - 2015-08-26 First page - n/a

Endnote Keywords

0769:Health care management

Short TitleEssays on Health Economics
Citation Key6351