Publications

November 1995 (Revised April 1998)
Case

National Insurance Corporation

The case visits the catastrophe insurance business at an interesting time in the history of the insurance markets. A major reinsurer, National Insurance, is taking a look at the new insurance derivatives being traded on the Chicago Board of Trade with a view to using... View Details

Keywords: Risk Management; Insurance; Capital Markets; Insurance Industry; United States

August 2012 (Revised December 2023)
Background Note

Note on Health Insurance Coverage, Coding, and Payment

By: Regina E. Herzlinger and Jo Ellen Slurzberg

This note explains how health care technology and service innovators receive payment from government insurers, in the U.S. and abroad, and from private insurers. It describes each of the three steps needed to obtain reimbursement: coverage, coding, and payment. It also... View Details

Keywords: Health Care Delivery; Health Care Costs; Health Insurance; Health Insurance Marketplaces; Health Care and Treatment; Cost; Insurance; Innovation and Invention; Private Sector; Public Sector; Decision Making; Information Technology; Health Industry; Health Industry

February 2019
Article

Does It Matter If Your Health Insurer Is For Profit? Effects of Ownership on Premiums, Insurance Coverage, and Medical Spending

By: Leemore S. Dafny

There is limited empirical evidence about the impact of for-profit health insurers on various outcomes. I study the effects of conversions to for-profit status by Blue Cross Blue Shield (BCBS) affiliates in 11 states, spanning 28 geographic markets. I find both the... View Details

Keywords: Health Insurance; Medical Loss Ratio; Blue Cross; Corporate Governance; Health; Insurance; For-Profit Firms; Insurance Industry; United States

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2019
Working Paper

Thinking Outside the Box (12): The Benefits of Increased Transparency in Employer-Sponsored Health Insurance for the 180 Million Insured

By: Regina E. Herzlinger and Barak D. Richman

Economists have long noted that the tax exclusion of employer-sponsored insurance (ESI) caused workers to purchase health plans that differ in price and other characteristics from those they would otherwise choose for themselves. We explore the short-term and long-term... View Details

Keywords: After-tax Income; Consumer-driven Health Care; Health Care Costs; Health Insurance; Income Inequality; Tax Policy; Health Care and Treatment; Cost; Insurance; Income; Equality and Inequality; Taxation; Policy; United States

05 Jul 2016
News

Health Insurance Stores and Health Hubs

August 2001 (Revised February 2020)
Case

Consumer-Driven Health Care: Medtronic's Health Insurance Options

By: Regina E. Herzlinger, John Hurwitch and Seth Bokser

Describes the variety of health insurance plans that this medical device company offers, including a high-deductible, consumer-driven health plan with a health reimbursement account that also enables health care providers to quote their own prices. Asks students to... View Details

Keywords: Health Care and Treatment; Insurance; Decision Choices and Conditions; Compensation and Benefits; Demand and Consumers

December 1993 (Revised December 1994)
Case

Patriot National Insurance Company

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August 2018 (Revised August 2019)
Case

Oscar Health Insurance: What Lies Ahead for a Unicorn Insurance Entrant?

By: Leemore Dafny and Victoria Marone

Keywords: Oscar Insurance; Fintech; US Health Care; Affordable Care Act (ACA); Health Insurance Marketplaces; Insurer Competition; Provider Consolidation; Market Entry; Health Care and Treatment; Entrepreneurship; Market Entry and Exit; Negotiation; Growth Management; Health Industry; Health Industry; New York (state, US); New Jersey

Article

Consumers' Misunderstanding of Health Insurance

By: George Loewenstein, Joelle Y. Friedman, Barbara McGill, Sarah Ahmad, Suzanne Linck, Stacey Sinkula, John Beshears, James J. Choi, Jonathan Kolstad, David Laibson, Brigitte C. Madrian, John A. List and Kevin G. Volpp

We report results from two surveys of representative samples of Americans with private health insurance. The first examines how well Americans understand, and believe they understand, traditional health insurance coverage. The second examines whether those insured... View Details

Keywords: Behavioral Economics; Simplification; Insurance; Consumer Behavior; Health Care and Treatment; Cognition and Thinking; Insurance Industry; Insurance Industry; United States

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Awards

Private Company Board of the Year

By: Jill J. Avery

Awarded the 2016 Private Company Board of the Year by the National Association of Corporate Directors, New England Chapter, along with the other corporate directors of the Amica Mutual Insurance Company. View Details

December 9, 2020
Article

Give Employees Cash to Purchase Their Own Insurance

By: Regina E. Herzlinger and Barak D. Richman

Employers’ and employees’ health care costs continue to skyrocket. A solution is to allow employers to give employees pre-tax cash to purchase their own health insurance. This move, enabled by a newly enacted federal rule, would put competitive pressure on insurers,... View Details

Keywords: Health Insurance; Health Care and Treatment; Insurance; Employees; Government Legislation

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2016
Working Paper

Entrepreneurship and Public Health Insurance

By: Gareth Olds

I examine the relationship between public health insurance and firm formation. Developing a variant of regression discontinuity, I find the Child Health Insurance Program lowered the child uninsured rate by 40% and increased self-employment by 15%. Monte Carlo evidence... View Details

Keywords: Insurance; Entrepreneurship

August 2013 (Revised August 2014)
Case

Aon Hewitt's Private Health Insurance Exchange

By: Regina E. Herzlinger, Aiden Y. Feng and Meghan D. Oliver

Aon Hewitt, a leading health insurance broker and consultant, is one of the first movers in forming exchanges to sell health insurance. What kinds of products should it offer on this exchange? View Details

Keywords: Health Care and Treatment; Insurance

Article

Behavioral Hazard in Health Insurance

By: Katherine Baicker, Sendhil Mullainathan and Joshua Schwartzstein

A fundamental implication of standard moral hazard models is overuse of low-value medical care because copays are lower than costs. In these models, the demand curve alone can be used to make welfare statements, a fact relied on by much empirical work. There is ample... View Details

Keywords: Insurance; Consumer Behavior; Health Care and Treatment; Insurance Industry

24 Jun 2016
News

Health insurance mergers put consumers last

03 Jan 2014
News

This Is Not Your Parents' Health Insurance

20 Apr 2017
News

Making Health Insurance That Consumers Actually Like

February 2018
Case

Health Savings Accounts: Enabling Consumer Participation

By: Regina E. Herzlinger and James Wallace

Health savings accounts (HSAs), a creation of the 2003 Medicare Modernization Act, had become an integral part of the drive toward consumer-driven health care. Coupled with high-deductible health plans, HSAs allowed consumers to directly control a significant part of... View Details

Keywords: Health Care; Healthcare Costs; Health Insurance; Health Care and Treatment; Cost; Insurance; Innovation and Invention; Health Industry; United States