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消除健康方面的麻烦:同伴和健康重要吗?

Taking the hassle out of wellness: Do peers and health matter?

作者信息

Danagoulian Shooshan

机构信息

Department of Economics, Wayne State University, Detroit, MI, USA.

出版信息

Int J Health Econ Manag. 2018 Mar;18(1):1-23. doi: 10.1007/s10754-017-9221-0. Epub 2017 Aug 31.

Abstract

Despite substantial financial incentives provided by the Affordable Care Act and employers, employee enrollment in wellness programs is low. This paper studies enrollment in a wellness program offered along an employer-provided health insurance plan. Two factors are considered in the choice of health plan with wellness: the effect of peer choices and family health on plan choice. Using exclusively obtained data of health insurance plan choice and utilization, this paper compares similar plans and focuses on a subsample of new employees. Result show that peers affect own choice of health insurance: a 10 percentage point rise in the share of colleagues enrolled in Aetna Wellness increases the probability of own enrollment in the plan by up to 3.9 percentage points. This result suggests that lack of experience with a wellness program are key to employee reluctance to enroll. Health effect on probability of enrollment in Aetna Wellness ranges from a 3 percentage point decline to a 3 percentage point rise depending on the measure, suggesting that while wellness programs appeal to low- to medium-intensity users of medical services, they do not appeal to individuals with more severe medical conditions which might benefit most from better coordinated medical care.

摘要

尽管《平价医疗法案》和雇主提供了大量经济激励措施,但员工参加健康计划的比例仍然很低。本文研究了在雇主提供的健康保险计划中提供的一项健康计划的参保情况。在选择带有健康计划的健康保险时考虑了两个因素:同伴选择和家庭健康对计划选择的影响。本文仅使用获得的健康保险计划选择和使用数据,比较了类似的计划,并重点关注新员工的一个子样本。结果表明,同伴会影响自己对健康保险的选择:参加安泰健康计划的同事比例每上升10个百分点,自己参加该计划的概率就会提高3.9个百分点。这一结果表明,缺乏健康计划的体验是员工不愿参保的关键。健康状况对参加安泰健康计划概率的影响,根据衡量标准的不同,从下降3个百分点到上升3个百分点不等,这表明虽然健康计划对低至中等强度的医疗服务使用者有吸引力,但它们对那些可能从更好的协调医疗护理中获益最大的患有更严重疾病的个人没有吸引力。

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