Person: Dafny, Leemore
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Dafny
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Leemore
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Dafny, Leemore
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Publication Narrow Networks On The Health Insurance Marketplaces: Prevalence, Pricing, And The Cost Of Network Breadth(Health Affairs (Project Hope), 2017-09) Dafny, Leemore; Hendel, Igal; Marone, Victoria; Ody, ChristopherAnecdotal reports and systematic research highlight the prevalence of narrow-network plans on the Affordable Care Act’s health insurance Marketplaces. At the same time, Marketplace premiums in the period 2014–2016 were much lower than projected by the Congressional Budget Office in 2009. Using detailed data on the breadth of both hospital and physician networks, we studied the prevalence of narrow networks and quantified the association between network breadth and premiums. Controlling for many potentially confounding factors, we found that a plan with narrow physician and hospital networks was 16% cheaper than a plan with broad networks for both, and that narrowing the breadth of just one type of network was associated with a 6%–9% decrease in premiums. Narrow-network plans also have a sizable impact on federal outlays, as they depress the premium of the second-lowest-price silver plan, to which subsidy amounts are linked. Holding all else constant, we estimate that federal subsidies would have been 10.8% higher in 2014 had Marketplaces required all plans to offer broad provider networks. Narrow networks are a promising source of potential savings for other segments of the commercial insurance market.Publication Treatment Of Opioid Use Disorder Among Commercially Insured US Adults, 2008–17(Health Affairs (Project Hope), 2020-06-01) Shen, Karen; Barrette, Eric; Dafny, LeemorePublication Does It Matter If Your Health Insurer Is For Profit? Effects of Ownership on Premiums, Insurance Coverage, and Medical Spending(American Economic Association, 2019-02-01) Dafny, LeemoreThere 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 and Blue Shield (BCBS) affiliates in 11 states, spanning 28 geographic markets. I find both the BCBS affiliate and its rivals increased premiums following conversions in markets where the converting affiliate had substantial market share. Medicaid enrollment rates also increased in these markets, a pattern consistent with “crowd in” of families who were formerly privately insured. The results suggest for-profit insurers are likelier than not-for-profit insurers to exercise market power when they possess it. (JEL G22, I13, I18, I38)Publication Does CVS–Aetna Spell the End of Business as Usual?(New England Journal of Medicine (NEJM/MMS), 2018-02-15) Dafny, Leemore