Who funds their health savings account and why?

Health savings account (HSA) enrollment has increased markedly in the last several years, but little is known about the factors affecting account funding decisions. We use a unique data set containing from a bank that exclusively services HSA funds linked to health status, benefit design, plan coverage, and enrollee characteristics from a very large national health insurance company to examine the factors associated with HSA contribution. We found that even small employer contributions had an apparently large effect on the decision to open an account: the account-opening rate was 50 % higher when employers contributed to the account. Conditional on opening an HSA, employee contributions were negatively associated with the amount of employer contribution, contributions rose with age, income, education, and health care need.

Differences In Starting Pay For Male And Female Physicians Persist; Explanations For The Gender Gap Remain Elusive.

A large literature has documented differences in salary between male and female physicians. While few observers doubt that women earn less, on average, than men do, the extent to which certain factors contribute to the salary difference remains a topic of considerable debate. Using ordinary least squares regression and Oaxaca-Blinder decomposition models for new physicians who accepted positions in patient care for the years 1999-2017, we examined how the gender gap in total starting pay evolved and the extent to which preferences in work-life balance factors affect the gap. We found that the physician earnings gap between men and women persisted over the study period. Interestingly, despite important gender differences in preferences for control over work-life balance, such factors had virtually no ability to explain the gender difference in salary. The implication is that there remain unmeasured factors that result in a large pay gap between men and women.

Immigrants and employer-sponsored health insurance.

OBJECTIVE: To investigate the factors underlying the lower rate of employer-sponsored health insurance coverage for foreign-born workers. DATA SOURCES: 2001 Survey of Income and Program Participation. STUDY DESIGN: We estimate probit regressions to determine the effect of immigrant status on employer-sponsored health insurance coverage, including the probabilities of working for a firm that offers coverage, being eligible for coverage, and taking up coverage. DATA EXTRACTION METHODS: We identified native born citizens, naturalized citizens, and noncitizen residents between the ages of 18 and 65, in the year 2002. PRINCIPAL FINDINGS: First, we find that the large difference in coverage rates for immigrants and native-born Americans is driven by the very low rates of coverage for noncitizen immigrants. Differences between native-born and naturalized citizens are quite small and for some outcomes are statistically insignificant when we control for observable characteristics. Second, our results indicate that the gap between natives and noncitizens is explained mainly by differences in the probability of working for a firm that offers insurance. Conditional on working for such a firm, noncitizens are only slightly less likely to be eligible for coverage and, when eligible, are only slightly less likely to take up coverage. Third, roughly two-thirds of the native/noncitizen gap in coverage overall and in the probability of working for an insurance-providing employer is explained by characteristics of the individual and differences in the types of jobs they hold. CONCLUSIONS: The substantially higher rate of uninsurance among immigrants is driven by the lower rate of health insurance offers by the employers of immigrants.

The effect of narrow provider networks on health care use.

Network design is an often overlooked aspect of health insurance contracts. Recent policy factors have resulted in narrower provider networks. We provide plausibly causal evidence on the effect of narrow network plans offered by a large national health insurance carrier in a major metropolitan market. Our econometric design exploits the fact that some firms offer a narrow network plan to their employees and some do not. Our results show that narrow network health plans lead to reductions in health care utilization and spending. We find evidence that narrow networks save money by selecting lower cost providers into the network.

Consumer-driven health plans: are they more than talk now?

This paper reports marketplace developments for consumer-driven health plans in spring 2002. Findings are from interviews with executives from start-up and health insurance firms, benefit consultants, employee benefit managers, Wall Street analysts, consumer organizations, thought leaders, and policymakers. We detail available evidence about the performance of consumer-driven health plans concerning access to care, risk selection, cost containment, use of information, and legal issues. We find that these health plans are now a central pillar of health insurers' business strategy and that an estimated 1.5 million persons are enrolled in them.