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NATIONAL BUREAU OF ECONOMIC RESEARCH

NBER Working Papers by Jacob Glazer

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Working Papers

March 2014Risk Adjustment of Health Plan Payments to Correct Inefficient Plan Choice from Adverse Selection
with Thomas McGuire, Julie Shi: w19998
This paper develops and implements a statistical methodology to account for the equilibrium effects (aka adverse selection) in design of risk adjustment formula in health insurance markets. Our setting is modeled on the situation in Medicare and the new state Exchanges where individuals sort themselves between a discrete set of plan types (here, two). Our "Silver" and "Gold" plans have fixed characteristics, as in the well-known research on selection and efficiency by Einav and Finkelstein (EF). We build on the EF model in several respects, including by showing that risk adjustment can be used to achieve the premiums that will lead to efficient sorting. The target risk adjustment weights can be found by use of constrained regressions, where the constraints in the estimation are conditi...

Forthcoming: Risk Adjustment of Health Plan Payments to Correct Inefficient Plan Choice from Adverse Selection, Jacob Glazer, Thomas G. McGuire, Julie Shi. in Measuring and Modeling Health Care Costs, Aizcorbe, Baker, Berndt, and Cutler. 2014

December 1998Measuring Adverse Selection in Managed Health Care
with Richard G. Frank, Thomas G. McGuire: w6825
Health plans paid by capitation have an incentive to distort the quality of services they offer to attract profitable and to deter unprofitable enrollees. We characterize plans' rationing as imposing a show that the profit maximizing shadow price depends on the dispersion in health costs, how well individuals forecast their health costs, the correlation between use in different illness categories, and the risk adjustment system used for payment. We further show how these factors can be combined in an empirically implementable index that can be used to identify the services that will be most distorted in competition among managed care plans. A simple welfare measure is developed to quantify the distortion caused by selection incentives. We illustrate the application of our ideas with a ...

Published: Frank, Richard G., Jacob Glazer and Thomas G. McGuire. "Measuring Adverse Selection In Managed Health Care," Journal of Health Economics, 2000, v19(6,Nov), 829-854.

September 1989Striking for a Bargain Between Two Completely Informed Agents
with Raquel Fernandez: w3108
This paper models the wage-contract negotiation procedure between a union and a firm as a sequential bargaining process in which the union also decides, in each period, whether or not to strike for the duration of that period. We show that there exist subgame-perfect equilibria in which the union engages in several periods of strikes prior to reaching a final agreement, although both parties are completely rational and fully informed. This has implications for other inefficient phenomena such as tariff wars, debt negotiations, and wars in general. We characterize the set of equilibria, show that strikes can occur in real time, and discuss extensions of the model such as lockouts and the possibility of multiple recontracting opportunities.

Published: American Economic Review, March 1991. citation courtesy of

May 1989The Scope for Collusive Behavior Among Debtor Countries
with Raquel Fernandez: w2980
We study the question of whether there exist strategies whereby countries are able to sustain a cartel or collusive behavior when bargaining with a bank over the amount of debt to be repaid. We show that despite the existence of economies to scale in bargaining--if commitment were possible the countries would benefit from joint bargaining--a debtors' cartel will not emerge in equilibrium (in the absence of credible commitment mechanisms). A unique subgame-perfect equilibrium exists in which the bank is effectively able to isolate each country and extract from each the same payoff that it would obtain in the absence of economies to scale. Consequently, a country would be better off if another country declared default. We also show that if two countries of unequal size are bargaining with a ...

Published: Journal of Development Economics, Vol. 32 (1990): 297-313. citation courtesy of

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