Technological Change and Risk Adjustment: Benefit Design Incentives in Medicare Part D
研究了技术变革（新药上市和仿制药竞争）如何改变医疗保险D部分中不同诊断的盈利性，进而影响保险公司设计福利的激励，发现风险调整未能完全消除保险公司通过福利设计进行风险选择的动机。
Subsidized health insurance markets use diagnosis-based risk adjustment to induce insurers to offer an equitable benefit to individuals of varying expected cost. I demonstrate that technological change after risk adjustment calibration—new drug entry and the onset of generic competition—made certain diagnoses profitable or unprofitable in Medicare Part D. I then exploit variation in diagnoses' profitability driven by technological change to show insurers designed more favorable benefits for drugs that treat profitable diagnoses as compared to unprofitable diagnoses. In the presence of technological change, risk adjustment may not fully neutralize insurers' incentives to select through benefit designs.