Restrictive Rating and Adverse Selection in Health Insurance

Born, Patricia; Sirmans, E. Tice

doi:10.1111/jori.12282

Cited by 6 publications

(1 citation statement)

References 48 publications

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“…Adverse selection plays an important role in the decision to buy a health insurance plan. In the insurance market, adverse selection indicates that high-risk groups are more willing to buy insurance or choose high-benefit insurance, while low-risk groups tend to refuse insurance and choose low-benefit insurance ( 11 , 12 ). As the number of high-risk people increases, insurance costs will rise, and insurers will have to raise the premium, which will further lead to a crowding-out effect on the low-risk population and eventually make the insurance system unsustainable ( 13 ).…”

Section: Introductionmentioning

confidence: 99%

Adverse selection and health insurance decisions of young migrant workers: An empirical study in China

Wang

Gong²

2023

Front. Public Health

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Using data from the China Migrants Dynamic Survey (CMDS) in 2017, this study assessed adverse selection and the impact of mobility factors on adverse selection by analyzing two samples of young migrant workers. The results of the sample analysis showed that young migrant workers with higher health risks were more inclined to enroll in health insurance, indicating the presence of adverse selection. Mobility distance and settle intention have a heterogeneous effect on adverse selection, with young workers who migrate inter-provincially and intend to settle down being more susceptible. The analysis of the insured samples showed that the phenomenon of adverse selection was also evident in the choice of health insurance, with individuals with higher risks preferring Urban Employee Basic Medical Insurance (UEBMI), which has better financial coverage and benefits compared to Rural Residents' Basic Medical Insurance (URRBMI). The heterogeneity test confirmed that mobility distance plays a role in determining the likelihood of adverse selection, with inter-city and inter-province young migrant workers being more likely to show adverse selection.

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Section: Introductionmentioning

confidence: 99%

Adverse selection and health insurance decisions of young migrant workers: An empirical study in China

Wang

Gong²

2023

Front. Public Health

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Managed care or carefully managed? Management of underwriting profitability by health insurers

Born

Eastman

Sirmans

2021

Geneva Pap Risk Insur Issues Pract

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Consumers’ decision-making self-efficacy for service purchases: construct conceptualization and scale

Hale¹,

Thakur²,

Riggs³

et al. 2021

JSM

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Purpose The purpose of this study is to develop and validate a scale to determine the consumer’s level of decision-making self-efficacy for a high-involved service purchase, specifically the purchase of medical insurance. One question to ask is how service providers can help consumers purchase the services that best meet their needs? Before interventions can occur, it is necessary to benchmark consumers’ perceptions of their own decision-making control and abilities. Design/methodology/approach A scale that measures consumers’ service decision-making self-efficacy was developed using the principles established for scale development validation. A four-study approach was used to reach the research objective. Findings The research consisted of four studies designed to: generate items to measure consumer service decision-making self-efficacy (CSDMSE); purify the scale and assess its dimensionality (second-order structure); establish the reliability and validity of the scale; and establish norms to provide details on its usefulness for aiding consumers with service purchases. The scale was found to be a higher-order construct, comprising three lower-order constructs. Originality/value Research suggests that consumer self-efficacy may affect their decision-making. The greater the consumer’s self-efficacy for decision-making tasks, the more efficient the decision-making process strategies are expected to be. This is the purpose for which the CSDMSE scale measure was created: to understand how, where and when service professionals can assist consumers with making appropriate service-related decisions and purchases.

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Restrictive Rating and Adverse Selection in Health Insurance

Cited by 6 publications

References 48 publications

Adverse selection and health insurance decisions of young migrant workers: An empirical study in China

Adverse selection and health insurance decisions of young migrant workers: An empirical study in China

Managed care or carefully managed? Management of underwriting profitability by health insurers

Consumers’ decision-making self-efficacy for service purchases: construct conceptualization and scale

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