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Clemens Fuest - One of the best experts on this subject based on the ideXlab platform.
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temporary layoffs and unemployment insurance is Experience Rating desirable
German Economic Review, 2005Co-Authors: Julia Fath, Clemens FuestAbstract:. This paper explores how the introduction of an Experience-rated system of unemployment insurance affects employment and welfare in a model where implicit contracts between firms and workers give rise to wage rigidities and unemployment. In the literature, it has been argued that Experience-rated systems of unemployment insurance may reduce long-term employment as firms anticipate the higher costs of layoffs implied by Experience Rating. Our analysis shows that the introduction of Experience Rating may increase or decrease long-term employment but it unambiguously raises welfare.
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Experience Rating versus employment protection laws in a model where firms monitor workers
Social Science Research Network, 2005Co-Authors: Julia Fath, Clemens FuestAbstract:While layoff costs in the U.S. are mostly due to Experience-rated unemployment insurance, layoff costs in European labour markets are primarily a consequence of employment protection laws. In this paper we compare the effects of Experience Rating and employment protection laws on employment and welfare in a model where unemployment arises due to efficiency wage setting and where labour turnover is inefficiently high. We show that a revenue-neutral introduction of Experience Rating reduces labour turnover and increases employment and welfare. The introduction of employment protection laws may also reduce labour turnover but employment declines.
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Experience Rating versus employment protection laws in a model where firms monitor workers
The Scandinavian Journal of Economics, 2005Co-Authors: Julia Fath, Clemens FuestAbstract:While layoff costs in the U.S. are mostly due to Experience-rated unemployment insurance, layoff costs in European labour markets are primarily a consequence of employment protection laws. In this paper we compare the effects of Experience Rating and employment protection laws on employment and welfare in a model where unemployment arises due to efficiency wage setting and where labour turnover is inefficiently high. We show that a revenue-neutral
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temporary layoffs and unemployment insurance is Experience Rating desirable
Research Papers in Economics, 2002Co-Authors: Julia Fath, Clemens FuestAbstract:This paper explores how the introduction of an Experience rated system of unemployment insurance affects employment and welfare in a model where implicit contracts between firms and workers give rise to wage rigidities and unemployment. In the literature, it has been argued that Experience rated systems of unemployment insurance may reduce long term employment as firms anticipate the higher costs of layoffs implied by Experience Rating. Our analysis shows that, despite the higher costs of layoffs, the introduction of Experience Rating may increase long term employment. Moreover, it unambiguously increases welfare.
Bruce E Landon - One of the best experts on this subject based on the ideXlab platform.
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quality and Experience of outpatient care in the united states for adults with or without primary care
JAMA Internal Medicine, 2019Co-Authors: David M Levine, Bruce E Landon, Jeffrey A LinderAbstract:Importance The US health care system is typically organized around hospitals and specialty care. The value of primary care remains unclear and debated. Objective To determine whether an association exists between receipt of primary care and high-value services, low-value services, and patient Experience. Design, Setting, and Participants This is a nationally representative analysis of noninstitutionalized US adults 18 years or older who participated in the Medical Expenditure Panel Survey. Propensity score–weighted quality and Experience of care were compared between 49 286 US adults with and 21 133 adults without primary care from 2012 to 2014. Temporal trends were also analyzed from 2002 to 2014. Exposures Patient-reported receipt of primary care, determined by the 4 “Cs” of primary care: first-contact care that is comprehensive, continuous, and coordinated. Main Outcomes and Measures Thirty-nine clinical quality measures and 7 patient Experience measures aggregated into 10 clinical quality composites (6 high-value and 4 low-value services), an overall patient Experience Rating, and 2 Experience composites. Results From 2002 to 2014, the mean annual survey response rate was 58% (range, 49%-65%). Between 2012 and 2014, compared with respondents without primary care (before adjustment), those with primary care were older (50 [95% CI, 50-51] vs 38 [95% CI, 38-39] years old), more often female (55% [95% CI, 54%-55%] vs 42% [95% CI, 41%-43%]), and predominately white individuals (50% [95% CI, 49%-52%] vs 43% [95% CI, 41%-45%]). After propensity score weighting, US adults with or without primary care had the same mean numbers of outpatient (6.7 vs 5.9; difference, 0.8 [95% CI, −0.2 to 1.8];P = .11), emergency department (0.2 for both; difference, 0.0 [95% CI, −0.1 to 0.0];P = .17), and inpatient (0.1 for both; difference, 0.0 [95% CI, 0.0-0.0];P = .92) encounters annually, but those with primary care filled more prescriptions (mean, 14.1 vs 10.7; difference, 3.4 [95% CI, 2.0-4.7];P Conclusions and Relevance Receipt of primary care was associated with significantly more high-value care, slightly more low-value care, and better health care Experience. Policymakers and health system leaders seeking to improve value should consider increasing investments in primary care.
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the quality of outpatient care delivered to adults in the united states 2002 to 2013
JAMA Internal Medicine, 2016Co-Authors: David M Levine, Jeffrey A Linder, Bruce E LandonAbstract:Importance Widespread deficits in the quality of US health care were described over a decade ago. Since then, local, regional, and national efforts have sought to improve quality and patient Experience, but there is incomplete information about whether such efforts have been successful. Objective To measure changes in outpatient quality and patient Experience in the United States from 2002 to 2013. Design, Setting, and Participants We analyzed temporal trends from 2002 to 2013 using quality measures constructed from the Medical Expenditure Panel Survey (MEPS), a nationally representative annual survey of the US population that collects data from individual respondents as well as respondents’ clinicians, hospitals, pharmacies, and employers. Participants were noninstitutionalized US adults 18 years or older (range, 20 679-26 509 individuals each year). Measures Outpatient quality measures were compiled through a structured review of prior studies and measures endorsed by national organizations. Nine clinical quality composites (5 “underuse” composites, eg, recommended medical treatment; 4 “overuse” composites, eg, avoidance of inappropriate imaging) based on 39 quality measures; an overall patient Experience Rating; and 2 patient Experience composites (physician communication and access) based on 6 measures. Results From 2002 to 2013 (MEPS sample size, 20 679-26 509), 4 clinical quality composites improved: recommended medical treatment (from 36% to 42%; P P P P = .02). Two clinical quality composites worsened: avoidance of inappropriate medical treatments (from 92% to 89%) and avoidance of inappropriate antibiotic use (from 50% to 44%; P P Conclusions and Relevance Despite more than a decade of efforts, the clinical quality of outpatient care delivered to American adults has not consistently improved. Patient Experience has improved. Deficits in care continue to pose serious hazards to the health of the American public.
David M Levine - One of the best experts on this subject based on the ideXlab platform.
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quality and Experience of outpatient care in the united states for adults with or without primary care
JAMA Internal Medicine, 2019Co-Authors: David M Levine, Bruce E Landon, Jeffrey A LinderAbstract:Importance The US health care system is typically organized around hospitals and specialty care. The value of primary care remains unclear and debated. Objective To determine whether an association exists between receipt of primary care and high-value services, low-value services, and patient Experience. Design, Setting, and Participants This is a nationally representative analysis of noninstitutionalized US adults 18 years or older who participated in the Medical Expenditure Panel Survey. Propensity score–weighted quality and Experience of care were compared between 49 286 US adults with and 21 133 adults without primary care from 2012 to 2014. Temporal trends were also analyzed from 2002 to 2014. Exposures Patient-reported receipt of primary care, determined by the 4 “Cs” of primary care: first-contact care that is comprehensive, continuous, and coordinated. Main Outcomes and Measures Thirty-nine clinical quality measures and 7 patient Experience measures aggregated into 10 clinical quality composites (6 high-value and 4 low-value services), an overall patient Experience Rating, and 2 Experience composites. Results From 2002 to 2014, the mean annual survey response rate was 58% (range, 49%-65%). Between 2012 and 2014, compared with respondents without primary care (before adjustment), those with primary care were older (50 [95% CI, 50-51] vs 38 [95% CI, 38-39] years old), more often female (55% [95% CI, 54%-55%] vs 42% [95% CI, 41%-43%]), and predominately white individuals (50% [95% CI, 49%-52%] vs 43% [95% CI, 41%-45%]). After propensity score weighting, US adults with or without primary care had the same mean numbers of outpatient (6.7 vs 5.9; difference, 0.8 [95% CI, −0.2 to 1.8];P = .11), emergency department (0.2 for both; difference, 0.0 [95% CI, −0.1 to 0.0];P = .17), and inpatient (0.1 for both; difference, 0.0 [95% CI, 0.0-0.0];P = .92) encounters annually, but those with primary care filled more prescriptions (mean, 14.1 vs 10.7; difference, 3.4 [95% CI, 2.0-4.7];P Conclusions and Relevance Receipt of primary care was associated with significantly more high-value care, slightly more low-value care, and better health care Experience. Policymakers and health system leaders seeking to improve value should consider increasing investments in primary care.
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the quality of outpatient care delivered to adults in the united states 2002 to 2013
JAMA Internal Medicine, 2016Co-Authors: David M Levine, Jeffrey A Linder, Bruce E LandonAbstract:Importance Widespread deficits in the quality of US health care were described over a decade ago. Since then, local, regional, and national efforts have sought to improve quality and patient Experience, but there is incomplete information about whether such efforts have been successful. Objective To measure changes in outpatient quality and patient Experience in the United States from 2002 to 2013. Design, Setting, and Participants We analyzed temporal trends from 2002 to 2013 using quality measures constructed from the Medical Expenditure Panel Survey (MEPS), a nationally representative annual survey of the US population that collects data from individual respondents as well as respondents’ clinicians, hospitals, pharmacies, and employers. Participants were noninstitutionalized US adults 18 years or older (range, 20 679-26 509 individuals each year). Measures Outpatient quality measures were compiled through a structured review of prior studies and measures endorsed by national organizations. Nine clinical quality composites (5 “underuse” composites, eg, recommended medical treatment; 4 “overuse” composites, eg, avoidance of inappropriate imaging) based on 39 quality measures; an overall patient Experience Rating; and 2 patient Experience composites (physician communication and access) based on 6 measures. Results From 2002 to 2013 (MEPS sample size, 20 679-26 509), 4 clinical quality composites improved: recommended medical treatment (from 36% to 42%; P P P P = .02). Two clinical quality composites worsened: avoidance of inappropriate medical treatments (from 92% to 89%) and avoidance of inappropriate antibiotic use (from 50% to 44%; P P Conclusions and Relevance Despite more than a decade of efforts, the clinical quality of outpatient care delivered to American adults has not consistently improved. Patient Experience has improved. Deficits in care continue to pose serious hazards to the health of the American public.
Emile Tompa - One of the best experts on this subject based on the ideXlab platform.
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a comparative analysis of the financial incentives of two distinct Experience Rating programs
Journal of Occupational and Environmental Medicine, 2016Co-Authors: Emile Tompa, Christopher B Mcleod, Cam MustardAbstract:Objectives:The aim of this study was to compare the association between insurance premium incentives and claim outcomes in two different workers’ compensation programs.Methods:Regression models were run for claim outcomes using data from two Canadian jurisdictions with different Experience-Rating pr
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financial incentives of Experience Rating in workers compensation new evidence from a program change in ontario canada
Journal of Occupational and Environmental Medicine, 2013Co-Authors: Emile Tompa, Benjamin C Amick, Cam Mustard, Lynda S Robson, Sheilah Hoggjohnson, Ying Wang, Enqing Shen, Ron SaundersAbstract:OBJECTIVE: To investigate the incentive for primary and secondary prevention associated with Experience Rating in a retrospective workers' compensation program. METHODS: Panel data on 21,558 firms from 1998 to 2007 were used to estimate the relationship between the degree of Experience Rating and seven measures of workplace occupational health and safety outcomes. We focused on the impact of a policy change in 2004 in which the degree of Experience Rating was substantially increased for all firms. RESULTS: The 2004 increase in Experience Rating was associated with a reduction in the total, lost-time, no-lost-time, benefit days, permanent impairment, musculoskeletal disorder, and acute trauma claim rates. These observed changes follow secular trends. CONCLUSION: The association of Experience Rating with some claim outcomes and not others in some time periods suggests that firms may focus on claims and cost management practices.
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financial incentives in workers compensation an analysis of the Experience Rating programme in ontario canada
Policy and practice in health and safety, 2012Co-Authors: Emile Tompa, Hoggjohnson Sheilah, Benjamin C Amick, Wang Ying, Shen Enqing, Cam Mustard, Lynda S RobsonAbstract:AbstractObjectives: To investigate the incentive for health and safety and cost management at the firm level associated with the degree of Experience Rating in a retrospective workers’ compensation programme in Ontario, Canada.Methods: We use panel data on all firms in the principal Ontario Experience-Rating programme between 1998 and 2007 to estimate regression models of the relationship between the degree of Experience Rating and various claim rates. We control for firm characteristics and contextual factors that may be associated with the outcomes under investigation.Results: A higher degree of Experience Rating was found to be associated with a lower lost-time claim rate and a higher no-lost-time claim rate. The relationship with the total claim rate was insignificant. The degree of Experience Rating was also associated with outcomes that proxied for cost management practices.Conclusions: A higher degree of Experience Rating appears to be associated primarily with increased secondary prevention effort...
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a critical review of literature on Experience Rating in workers compensation systems
Policy and practice in health and safety, 2012Co-Authors: Mansfield Liz, Emile Tompa, Maceachen Ellen, Kalcevich Christina, Marion Endicott, Natalie YeungAbstract:AbstractIn this paper we present a review of the English language peer-reviewed literature on Experience Rating and critically examine the framing of research questions, methodology selection, study findings, the interpretation of results and underlying logic. Two main questions are addressed: what is known about how Experience Rating motivates employer and worker behaviour?; what is known about how Experience Rating affects workplace health and safety?We conducted a comprehensive search of quantitative and qualitative literature on Experience Rating and claims management. Studies were appraised on several key characteristics (eg central objective, relevance), study quality (eg study design, interpretation of results) and Experience-Rating findings (eg how it motivates stakeholders, other health and safety incentives, cost-shifting).While some qualitative studies consider claims management, we found that few focus directly on the topic of Experience Rating. Several of the qualitative studies do not adequa...
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update on a systematic literature review on the effectiveness of Experience Rating
Policy and practice in health and safety, 2012Co-Authors: Emile Tompa, Kim Cullen, Christopher B McleodAbstract:AbstractObjectives: The objective of this systematic review is to update the evidence on the effectiveness of Experience Rating of workers’ compensation insurance premiums in leading to improvements in workplace occupational safety and health performance.Methods: We update a review undertaken several years ago, using the same systematic review methodology. A rigorous and systematic literature search was completed. Studies that met subject matter and methods criteria underwent a quality assessment. Evidence from included studies was synthesised using a qualitative approach known as ‘best evidence’ synthesis. This approach ranks the strength of evidence based on the quantity, quality, and consistency of studies meeting the quality inclusion criteria.Results: In terms of the introduction of Experience Rating, based on six studies there was moderate evidence that its introduction is associated with a lower frequency of injuries. With respect to the degree of Experience Rating, based on seven studies there was...
Lu Yang - One of the best experts on this subject based on the ideXlab platform.
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Wishart‐gamma random effects models with applications to nonlife insurance
'Wiley', 2020Co-Authors: Denuit Michel, Lu YangAbstract:Random effects are particularly useful in insurance studies, to capture residual heterogeneity or to induce cross‐sectional and/or serial dependence, opening hence the door to many applications including Experience Rating and microreserving. However, their nonobservability often makes existing models computationally cumbersome in a multivariate context. In this paper, it is shown that the multivariate extension to the Gamma distribution based on Wishart distributions for random symmetric positive‐definite matrices (considering diagonal terms) is particularly tractable and convenient to model correlated random effects in multivariate frequency, severity and duration models. Three applications are discussed to demonstrate the versatility of the approach: (a) frequency‐based Experience Rating with several policies or guarantees per policyholder, (b) Experience Rating accounting for the correlation between claim frequency and severity components, and (c) joint modeling and forecasting of the time‐topayment and amount of payment in microlevel reserving, when both are subject to censoring
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Wishart-Gamma mixtures for multiperil Experience ratemaking, frequency-severity Experience Rating and micro-loss reserving
2020Co-Authors: Denuit Michel, Lu YangAbstract:This paper studies multivariate mixtures with Wishart-Gamma mixing distribution. Af- ter having recalled the definition and main properties of Wishart distributions for random symmetric positive definite matrices, it is shown how they can be used to extend Gamma distributions to the multivariate case, by considering the joint distribution of the diagonal terms. The resulting distribution, which we call Wishart-Gamma distribution, appears to be particularly useful to model correlated random effects in multivariate frequency, severity and duration models, leading to closed form likelihood function and posterior ratemak- ing formula. Three main applications are discussed to demonstrate the versatility of the Wishart-Gamma mixture models: (i) Experience Rating with several policies or guarantees per policyholder, (ii) Experience Rating taking into account the correlation between claim fre- quency and severity components, and (iii) dependence modeling between time-to-payment and amount of payment in micro-loss reserving when the ultimate payment is subject to censoring. Besides introducing the Wishart and Wishart-Gamma distributions, we are also among one of the first to employ the techniques such as fractional integral and symbolic calculation in the non-life actuarial literature
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pair copula constructions for insurance Experience Rating
Journal of the American Statistical Association, 2018Co-Authors: Peng Shi, Lu YangAbstract:In nonlife insurance, insurers use Experience Rating to adjust premiums to reflect policyholders’ previous claim Experience. Performing prospective Experience Rating can be challenging when the cla...
