Mark Shepard

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Retirees face significant uncertainty about how long they will live and, in many countries, how much costly health care they will require. Yet few buy life annuities or long-term care insurance to insure these risks. Low rates of long-term care insurance coverage are often interpreted as evidence against the importance of bequest motives since failing to(More)
OBJECTIVE To compare the clinical quality of care between Medicare fee-for-service (FFS) and Medicare Advantage (MA) programs. METHODS We compared 11 Healthcare Effectiveness Data and Information Set (HEDIS) quality measures nationwide for MA managed care plans and the FFS program in 2006 and 2007. We adjusted FFS measures to match the geographic(More)
Health insurers increasingly compete based on their networks of covered medical providers. Using data from Massachusetts’ pioneer insurance exchange, I show evidence of substantial adverse selection against plans covering the most expensive and prestigious academic hospitals. Individuals loyal to the prestigious hospitals both select plans covering them and(More)
In differentiated product markets, the entry and exit of individual product models— rather than of firms—often serve as the main equilibrating force. Market structure changes that lead to high prices also tend to encourage entry, partially offsetting the effects. Thus, accurately predicting changes from a merger or bankruptcy should incorporate this(More)
The US Medicare program consumes an ever-rising share of the federal budget. Although this public spending can produce health and social benefits, raising taxes to finance it comes at the cost of slower economic growth. In this article we describe a model incorporating the benefits of public programs and the cost of tax financing. The model implies that the(More)
OBJECTIVES To facilitate replication and adaptation of pediatric HIV disclosure interventions, we identified key components of a child-friendly cartoon book used to guide Namibian caregivers and healthcare workers (HCWs) through a gradual, structured disclosure process. DESIGN Qualitative interviews were conducted with caregivers and HCWs from four(More)
The 1990 Clean Air Act Amendments imposed extensive restrictions on refined petroleum product markets, requiring select end users to purchase new cleaner versions of gasoline and diesel. I estimate the impact of this intervention on refining costs, product prices and consumer welfare. Isolating these effects is complicated by several challenges likely to(More)
“Network adequacy regulations” expand patients’ access to hospitals by mandating a lower bound on the number of hospitals that health insurers must include in their networks. Such regulations, however, compromise insurers’ bargaining position with hospitals, which may increase hospital reimbursement rates, and may consequently be passed through to consumers(More)