TY  - RPRT
        AU  - Klein, Tobias J.
AU  - Salm, Martin
AU  - Upadhyay, Suraj
        TI  - The Response to Dynamic Incentives in Insurance Contracts with a Deductible: Evidence from a Differences-in-Regression-Discontinuities Design
        PY  - 2020/Mar/
        PB  - Institute of Labor Economics (IZA)
        CY  - Bonn
        T2  - IZA Discussion Paper
        IS  - 13108
        UR  - https://www.iza.org/index.php/publications/dp13108
        AB  - We develop a new approach to quantify how patients respond to dynamic incentives in health insurance contracts with a deductible. Our approach exploits two sources of variation in a differences-in-regression-discontinuities design: deductible contracts reset at the beginning of the year, and cost-sharing limits change over the years. Using rich claims-level data from a large Dutch health insurer we find that individuals are forward-looking. Changing dynamic incentives by increasing the deductible by €100 leads to a reduction in healthcare spending of around 3% on the first days of the year and 6% at the annual level. The response to dynamic incentives is an important part of the overall effect of cost-sharing schemes on healthcare expenditures- much more so than what the previous literature has suggested.
        KW  - health insurance
KW  - patient cost-sharing
KW  - dynamic incentives
        ER  -