Do insurers respond to active purchasing? Evidence from the Massachusetts health insurance exchange
研究了马萨诸塞州健康保险交易所的主动购买政策如何通过设定定价门槛和有限选择规则，促使保险公司降低价格，其中有限选择政策在2012-2014年使平均保费下降16%-20%。
Abstract Health insurance markets face continued challenges with high premiums and limited insurer competition. We describe a unique set of “active purchasing” policies used by Massachusetts' pioneer health insurance exchange to shape the rules of competition and reward lower‐price insurers with additional customers. We provide evidence that these policies significantly influenced insurer pricing. Between 2010 and 2013, over 80% of insurer prices were set exactly at or within 1% of pricing thresholds created by active purchasing policies. A key “limited choice” policy was associated with a 16%–20% reduction in average insurance prices relative to comparison markets in 2012–2014. Insurers achieved these price cuts partly through cost reductions via narrower provider networks and partly through reduced profit margins.