Mitigating Risk Selection in Healthcare Entitlement Programs: A Beneficiary-Level Competitive Bidding Approach
References
- (2017) Bundled payment vs. fee-for-service: Impact of payment scheme on performance. Management Sci. 63(5):1606–1624.Link, Google Scholar
- (2009) Designing intelligent software agents for auctions with limited information feedback. Inform. Systems Res. 20(4):507–526.Link, Google Scholar
- (2016) The impact of competing ads on click performance in sponsored search. Inform. Systems Res. 27(3):538–557.Link, Google Scholar
- (2018) Advertising and risk selection in health insurance markets. Amer. Econom. Rev. 108(3):828–867.Crossref, Google Scholar
- (2011) Competing “creatively” in sponsored search markets: The impact of rank, unique selling proposition, and competition on the effectiveness of sponsored search listings. Inform. Systems Res. 22(1):153–169.Link, Google Scholar
- (2020) Allocative efficiency in online auctions: Improving the performance of multiple online auctions via seek-and-protect agents. Production Oper. Management 29(8):1878–1893.Crossref, Google Scholar
- (2009) Overlapping online auctions: Empirical characterization of bidder strategies and auction prices. Management Inform. Systems Quart. 33(4):763–783.Crossref, Google Scholar
- (2004) User heterogeneity and its impact on electronic auction market design: An empirical exploration. Management Inform. Systems Quart. 28(1):21–43.Crossref, Google Scholar
- (2012) Do health plans risk-select? An audit study on Germany’s social health insurance. J. Public Econom. 96(9):750–759.Crossref, Google Scholar
- (2015) Mechanism choice and the buy-it-now auction: A structural model of competing buyers and sellers. Internat. J. Industry Organ. 38:19–31.Crossref, Google Scholar
- (2017) Frontiers in spectrum auction design. Internat. J. Industry Organ. 50:372–391.Crossref, Google Scholar
- (2007) Introduction to the special issue on e-auctions for procurement operations. Production Oper. Management 16(4):401–403.Crossref, Google Scholar
- (2010) Research commentary—Designing smart markets. Inform. Systems Res. 21(4):688–699.Link, Google Scholar
- Blue Cross Blue Shield (2009) Typical costs for common medical services. Technical report, Blue Cross Blue Shield of Massachusetts. https://www.bluecrossma.com/blue-iq/pdfs/TypicalCosts89717042709.pdf.Google Scholar
- (2014) How does risk selection respond to risk adjustment? New evidence from the Medicare Advantage Program. Amer. Econom. Rev. 104(10):3335–3364.Crossref, Google Scholar
- (1996) Auctions vs. negotiations. Amer. Econom. Rev. 86(1):180–194.Google Scholar
- (2011) An experimental study of information revelation policies in sequential auctions. Management Sci. 57(4):667–688.Link, Google Scholar
- Centers for Medicare & Medicaid Services (2016) HHS-operated risk adjustment methodology meeting. Discussion paper (Center for Consumer Information & Insurance Oversight). Accessed October 27, 2021, https://www.hhs.gov/guidance/sites/default/files/hhs-guidance-documents/RA_March_31_White_Paper_032416.pdf.Google Scholar
- (2009) Optimal collusion-proof auctions. J. Econom. Theory 144(2):565–603.Crossref, Google Scholar
- (2020) Market design, human behavior, and management. Management Sci. 67(9):5317–5348.Link, Google Scholar
- (2012) Fitness memberships and favorable selection in Medicare Advantage plans. New England J. Medicine 366(2):150–157.Crossref, Google Scholar
- (2014) Uncompensated care for the uninsured in 2013: A detailed examination. Report, Kaiser Family Foundation. Accessed October 27, 2021, https://www.kff.org/wp-content/uploads/2014/05/8596-uncompensated-care-for-the-uninsured-in-2013.pdf.Google Scholar
- (2012) Integrated block sharing: A win–win strategy for hospitals and surgeons. Manufacturing Service Oper. Management 14(4):567–583.Link, Google Scholar
- (2009) Accommodating individual preferences in nurse scheduling via auctions and optimization. Health Care Management Sci. 12(3):228.Crossref, Google Scholar
- Department of Health & Human Services (2016) Poverty guidelines 01/25/2016. Technical report, Office of the Assistant Secretary for Planning and Evaluation. Accessed October 27, 2021, https://aspe.hhs.gov/2016-poverty-guidelines.Google Scholar
- (1992) Organizing the health insurance market. Econometrica 60(6):1233–1254.Crossref, Google Scholar
- (2000) Risk selection and optimal health insurance-provider payment systems. J. Risk Insurance 67(2):173–196.Crossref, Google Scholar
- (2016) Beyond statistics: The economic content of risk scores. Amer. Econom. J. Appl. Econom. 8(2):195–224.Crossref, Google Scholar
- (2014) Risk selection and risk adjustment. Culyer AJ, ed. Encyclopedia of Health Economics (Elsevier, New York), 289–297.Crossref, Google Scholar
- (2013) Does service-level spending show evidence of selection across health plan types? Appl. Econom. 45(13):1701–1712.Crossref, Google Scholar
- (1996) Diagnosis-based risk adjustment for Medicare capitation payments. Health Care Financial Rev. 17(3):101.Google Scholar
- (1988) Managed competition of alternative delivery systems. J. Health Political Policy Law 13(2):305–321.Crossref, Google Scholar
- (2012) Competitive Bidding Can Help Solve Medicare’s Fiscal Crisis (Health Policy Outlook). Accessed October 27, 2021, https://www.aei.org/wp-content/uploads/2012/02/-competitive-bidding-can-help-solve-medicares-fiscal-crisis_081704430956.pdf?x91208.Google Scholar
- (2007) Releasing individually identifiable microdata with privacy protection against stochastic threat: An application to health information. Inform. Systems Res. 18(1):23–41.Link, Google Scholar
- (2020) Upcoding: Evidence from medicare on squishy risk adjustment. J. Political Econom. 128(3):984–1026.Google Scholar
- (2009) An agent-based approach to improving resource allocation in the dutch youth healthcare sector. Proc. Eur. Conf. Inform. Systems (Association for Information Systems), 2468–2479. Accessed October 27, 2021, https://aisel.aisnet.org/ecis2009/259.Google Scholar
- (2019) A view from the states: Key medicaid policy changes. Accessed October 27, 2021, https://www.kff.org/report-section/a-view-from-the-states-key-medicaid-policy-changes-methods/.Google Scholar
- (2016) “Buy-it-now” or “sell-it-now” auctions: Effects of changing bargaining power in sequential trading mechanisms. Econom. Lett. 142:27–30.Crossref, Google Scholar
- (2012) Competitive bidding for health insurance contracts: Lessons from the online hmo auctions. Internat. J. Health Care Finance Econom. 12(4):303–322.Crossref, Google Scholar
- (2013) Increasing revenue by decreasing information in procurement auctions. Production Oper. Management 22(1):19–35.Crossref, Google Scholar
- (1967) Put people on your balance sheet. Harvard Bus. Rev. 45(1):105–113.Google Scholar
- (2006) Buy-price English auction. J. Econom. Theory 129(1):31–56.Crossref, Google Scholar
- (2013) Online Labor Markets: An Informal Freelancer Economy (Fox School of Business, Temple University, Philadelphia). Accessed October 27, 2021, http://dx.doi.org/10.2139/ssrn.2132869.Google Scholar
- (2012) Medicaid and chip risk-based managed care in 20 states. Technical report, The Urban Institute. Accessed October 27, 2021, https://www.urban.org/sites/default/files/publication/25646/412617-Medicaid-and-CHIP-Risk-Based-Managed-Care-in-States.PDF.Google Scholar
- (2014) Income and assets of Medicare beneficiaries, 2013-2030. The Urban Institute. Accessed October 27, 2021, https://www.urban.org/research/publication/income-and-assets-medicare-beneficiaries-2013-2030.Google Scholar
- (2011) An automated and data-driven bidding strategy for online auctions. INFORMS J. Comput. 23(2):238–253.Link, Google Scholar
- (2001) Super-experienced bidders in first-price common-value auctions: Rules of thumb, Nash equilibrium bidding, and the winner’s curse. Rev. Econom. Statist. 83(3):408–419.Crossref, Google Scholar
- Kaiser Family Foundation (2016) Total Number of Medicare Beneficiaries, 2015. State Health Facts (Kaiser Family Foundation). Accessed October 27, 2021, https://www.kff.org/medicare/state-indicator/total-medicare-beneficiaries/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D.Google Scholar
- Kaiser Family Foundation (2017a) Number of Dual Eligible Beneficiaries. State Health Facts (Kaiser Family Foundation). Accessed October 27, 2021, https://www.kff.org/medicaid/state-indicator/dual-eligible-beneficiaries/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D.Google Scholar
- Kaiser Family Foundation (2017b) Total Monthly Medicaid and CHIP Enrollment, February 2017. State Health Facts (Kaiser Family Foundation). Accessed October 27, 2021, https://www.kff.org/health-reform/state-indicator/total-monthly-medicaid-and-chip-enrollment/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D.Google Scholar
- (2008) Will competitive bidding decrease Medicare prices? Southern Econom. J. 74(3):839–856.Crossref, Google Scholar
- (1992) Competitive bidding for health insurance contracts. Health Policy 21(1):35–46.Crossref, Google Scholar
- (2012) Emergency departments, Medicaid costs, and access to primary care: Understanding the link. New England J. Medicine 366(23):2141–2143.Crossref, Google Scholar
- (2020) Addressing societal challenges through analytics: An ESG ice framework and research agenda. J. Assoc. Inform. Systems 21(5):9.Google Scholar
- (2016) Competitive benchmarking: an is research approach to address wicked problems with big data and analytics. Management Inform. Systems Quart. 40(4):1057–1080.Crossref, Google Scholar
- (2009) Detecting and forecasting economic regimes in multi-agent automated exchanges. Decision Support Systems 47(4):307–318.Crossref, Google Scholar
- (2008) Pre-auction offers in asymmetric first-price and second-price auctions. Games Econom. Behav. 63(1):145–165.Crossref, Google Scholar
- (2015) Comparison of healthcare spending and utilization among children with Medicaid insurance. Pediatrics 136(6):1521–1529.Crossref, Google Scholar
- (2018) Does managed care widen infant health disparities? Evidence from Texas Medicaid. Amer. Econom. J. Econom. Policy 10(3):255–283.Crossref, Google Scholar
- (2011) Procurement contracting with time incentives: Theory and evidence. Quart. J. Econom. 126(3):1173–1211.Crossref, Google Scholar
- (2016) Exploring bidder heterogeneity in multichannel sequential b2b auctions. Management Inform. Systems Quart. 40(3):645–662.Crossref, Google Scholar
- (2019a) Dynamic decision making in sequential business-to-business auctions: A structural econometric approach. Management Sci. 65(8):3853–3876.Link, Google Scholar
- (2019b) Information transparency in business-to-business auction markets: The role of winner identity disclosure. Management Sci. 65(9):4261–4279.Link, Google Scholar
- (2013) A game-theoretic model of international influenza vaccination coordination. Management Sci. 59(7):1650–1670.Link, Google Scholar
- (2008) Reverse auctions: Benefits, challenges, and best practices. California J. Oper. Management 6(1):123–130.Google Scholar
- Mathematica Policy Research (2019) Medicaid managed care and integrated delivery systems: Technical assistance to states and strengthening federal oversight. Accessed October 27, 2021, https://www.mathematica-mpr.com/our-publications-and-findings/projects/integrated-delivery-systems.Google Scholar
- (2004) The impact of discounting on an auction with a buyout option: A theoretical analysis motivated by ebay’s buy-it-now feature. J. Econom. 81(1):25–52.Google Scholar
- (2013) Integrating risk adjustment and enrollee premiums in health plan payment. J. Health Econom. 32(6):1263–1277.Crossref, Google Scholar
- (2012) New risk-adjustment system was associated with reduced favorable selection in Medicare Advantage. Health Affairs 31(12):2630–2640.Crossref, Google Scholar
- (2010) Medicare’s opportunity to encourage innovation in healthcare delivery. New England J. Medicine 362(9):772–774.Crossref, Google Scholar
- (1981) Optimal auction design. Math. Oper. Res. 6(1):58–73.Link, Google Scholar
- (1996) Reimbursing health plans and health providers: Efficiency in production vs. selection. J. Econom. Literature 34(3):1236–1263.Google Scholar
- (1991) How competitive is competitive bidding? Health Affairs 10(4):220–230.Crossref, Google Scholar
- (2008) Auction design in the presence of collusion. Theoretical Econom. 3:383–429.Google Scholar
- (2019) Optimal auction design for wi-fi procurement. Inform. Systems Res. 30(1):1–14.Link, Google Scholar
- (2009) Auctions with a buy price. Econom. Theory 38(1):9–39.Crossref, Google Scholar
- (1981) Optimal auctions. Amer. Econom. Rev. 71(3):381–392.Google Scholar
- (2015) Automated design of revenue-maximizing combinatorial auctions. Oper. Res. 63(5):1000–1025.Link, Google Scholar
- (2009) Auctions with a buy price: The case of reference-dependent preferences. Games Econom. Behav. 67(2):645–664.Crossref, Google Scholar
- (2013) Competitive bidding in Medicare Advantage: Effect of benchmark changes on plan bids. J. Health Econom. 32(6):1301–1312.Crossref, Google Scholar
- (2019) Effective healthcare cost-containment policies: A systematic review. Health Policy 123(1):71–79.Crossref, Google Scholar
- (2004) Comparing accuracy of risk-adjustment methodologies used in economic profiling of physicians. J. Healthcare Organ., Provision, Financing 41(2):218–231.Crossref, Google Scholar
- (2014) An empirical analysis of price, quality, and incumbency in procurement auctions. Manufacturing Service Oper. Management 16(3):346–364.Link, Google Scholar
- (2020) Sustainable electric vehicle charging using adaptive pricing. Production Oper. Management 29(6):1550–1572.Crossref, Google Scholar
- (2003) Risk adjustment and risk selection on the sickness fund insurance market in five European countries. Health Policy 65(1):75–98.Crossref, Google Scholar
- (2008) When auction meets fixed price: A theoretical and empirical examination of buy-it-now auctions. Quantitative Marketing Econom. 6(4):339.Crossref, Google Scholar
- World Bank (2017) GDP per Capita (Current US$). National Accounts Data (The World Bank).Google Scholar
- (2010) Buy-price auction: A distributional approach. Econom. Lett. 107(3):345–349.Crossref, Google Scholar

