Insurance Participation Research Articles

An Empirical Analysis of Insurer Participation in the U.S. Cyber Insurance Market

The U.S. property-casualty insurance industry has witnessed substantial growth in the cyber insurance market over the past decade, largely attributable to the proliferation of technology in the business world paired with the greater occurrence of cyber-related loss activity. While cyber insurance plays an increasingly important role both in the insurance industry and in the worldwide economy, relatively little is known about participation and performance in the cyber insurance market. Using a unique panel dataset made available through recent mandatory disclosures, we examine market trends, factors associated with market participation, and firm-specific characteristics related to performance. Among our findings, the results indicate that the cyber insurance market is highly concentrated and that firm-specific characteristics such as size, business mix, reinsurance, and organizational structure tend to impact both participation and the extent of participation in the market. Furthermore, we show that classification as an excess and surplus (E&S) lines insurer and group affiliation are particularly significant drivers of cyber market involvement. Finally, we offer evidence that while cyber insurance is a profitable line of business for market participants, factors such as insurer size, reinsurance use, diversification, group affiliation, organizational structure, and status as an E&S insurer each influence performance in different and important ways.

Analysis of farmers satisfaction on the services quality of cattle insurance program in Manuju District, Gowa Regency

The Livestock and Animal Health Service Office of South Sulawesi Province stated that in 2017 beef cattle in Gowa Regency registered in insurance reached 1,367, while in 2018 decreased significantly to 1,140. The decrease in number of insured cattle indicates a decrease in the number of farmers participating in the insurance program. This study aims to determine the Satisfaction Index of cattle farmers on the services quality of Cattle Insurance Program in Manuju District, Gowa Regency. This study was conducted from May to July 2019 with a type of descriptive quantitative research. The sample used was 50 participants who are/were insurance participants. The data collected through literature study, interviews and questionnaires. The data analysed with two methods of Customer Satisfaction Index (CSI) and Importance Performance Analysis (IPA). The results indicate that the Customer Satisfaction Index (CSI) of farmers is 68.49% which included in the category of Good. The top priority attributes in service quality of Cattle Insurance Program, namely Punctuality of claims payment, Management of administration and Clarity of CIP information.

Optimal Demand for Index Insurance Under Basis Ambiguity

This study examines how basis ambiguity influences the demand for index insurance. Ambiguity is introduced into the statistical relationship between the loss and the index because they are more difficult to guess than the occurrence of the loss and the index individually. Basis ambiguity lowers the demand for index insurance and increases the threshold to hold the index insurance. This is a possible explanation for the very low demand and participation in index insurance. Further, we consider how changes in ambiguity and ambiguity aversion influence the demand.

The ACA's Effect On The Individual Insurance Market.

The vision of the Affordable Care Act (ACA) for a reformed individual health insurance market included requirements and incentives for insurers to manage risk instead of avoiding it, minimum standards for coverage adequacy, income-related subsidies, managed competition through health insurance Marketplaces, and new programs to promote insurer competition. Against this vision, we assessed how insurance markets evolved between 2014 and 2019, using metrics such as premium changes, insurer participation, and enrollment. We also assessed how federal and state policy choices during the implementation of the ACA may have affected market performance. The article closes with an assessment of recent federal-level policy choices and the evidence to date about their effect on insurance markets, together with a discussion of how market experience under the ACA can inform policy makers who seek to further expand consumers' access to affordable, comprehensive coverage.

An Initial Analysis of the Effects of a Long-Term Care Insurance on Equity and Efficiency: A Case Study of Qingdao City in China.

Finding a suitable mechanism to finance long-term care (LTC) is a pressing policy concern for many countries. Using Qingdao city in China as a case study, this article presents an initial assessment of a newly piloted LTC insurance by evaluating its effects on equity and efficiency in financing. Drawing data from 47 in-depth interviews conducted in 2016, this study found that there remain sizable disparities in financial burden among insurance participants, despite an emphasis on ensuring equitable access to care. Although the insurance brought cost savings to the health care sector, the LTC providers are incentivized to provide care at the least cost, even when such care is deemed inadequate due to the fixed payment for their services. This article offers critical insights into the potentials and challenges of applying the LTC insurance model in a developing country, where critical lessons can be drawn for public LTC insurance in other countries.

Determinan Keputusan Pekerja Mandiri menjadi Peserta Jaminan Kesehatan Nasional

Background: National health insurance is mandatory for all Indonesians. In Ogan Ilir Regency, the lowest percentage (24,14%) of its participants in December 2016 was found in Indralaya Utara Sub-district, and self-employed participants in this sub-district were only 6,99%. This study aimed to analyze the determinants of the self-employed’s decision to become national health insurance participants in Indralaya Utara Sub-district. Method: This was a cross-sectional study. The population was self-employed in Indralaya Utara Sub-district. The sample was 108 respondents who were selected using cluster sampling and consecutive sampling techniques. Data analysis was conducted by univariate and bivariate with chi-square statistical test. Results: The results illustrated that 18,52% of respondents decided to become national health insurance participants. Variables with p-value<0,005 were: knowledge about national health insurance (p-value=0,011), trust (p-value=0.000), perception about national health insurance (p-value=0,000), attitude (p-value=0,000), income (p-value=0,002), family support (p-value=0,005). Variables with p-value≥0,005 were: education (p-value=0,234), perception about health facilities (p-value=0,162), distance to health facilities (p-value=0,355), health workers support (p-value=0,112). Conclusion: In conclusion, percentage of self-employed who decided become national health insurance participants was still small. Associated factors to the decision of self-employed as participants were: knowledge about national health insurance, trust, perception about national health insurance, attitude, income and family support. It is suggested that the Social Security Administrative Body for Health should routinely conduct socialization on national health insurance to improve the percentage of its participation for self-employed and the benefits of national health insurance could be felt by the entire community.

Influence of farm size and insured type on crop insurance returns

AbstractIn this article, we empirically examine the impact of farm size and insured type on returns from crop insurance participation in four regions using unit‐level crop insurance contract data. Our quasi‐panel empirical model provides guidance on whether larger producers are riskier than smaller producers and whether cash producers are riskier than landlords. In our sample, we did not find evidence that large producers obtain higher returns from insurance participation than their smaller counterparts. In fact, we found evidence of the opposite that larger producers in Iowa and Nebraska receive less than their smaller counterparts. Our farm size results suggest that any legislation limiting crop insurance participation from large producers would negatively influence the insurance pool, driving up premiums and consequently administrative and operational subsidies and per‐acre premium subsidy dollars. We did find evidence that cash insured types get more back in insurance than landlords in both Montana and Oklahoma, suggesting the possibility of moral hazard in input usage. Our results also highlight spatial differences in crop insurance outcomes.

ANALYSIS OF SATISFACTION OF NATIONAL HEALTH INSURANCE JKN PARTICIPANTS THROUGH QUALITY OF MOBILE SERVICES AND CONFIDENCE MEDIATED BY DECISION TO CHOOSE MOBILE JKN SERVICE ON BPJS KESEHATAN OF PEKANBARU

The purpose of this study is to find out how Analysis of Satisfaction of National Health Insurance JKN Participants through Quality of Mobile Services and Confidence Mediated by Decision to Choose Mobile JKN Service on BPJS Kesehatan of Pekanbaru, by measuring indicators that influence variables service quality, trust, decision and satisfaction. This research applies a descriptive research design using survey methods. Sampling uses certain criteria where the respondent is a health insurance participant as a sampling technique. This study was tested using the structural equation modeling (Lisrel) approach to test the significance of the significance of the overall model and predetermined pathway. The findings show that mobile service quality variables have a positive and significant effect on decisions, trust variables have a positive and significant effect on decisions, decision variables have a positive and significant effect on participant satisfaction, mobile service quality variables have a positive and significant effect on satisfaction and trust variables have a positive and significant effect on participant satisfaction.

Hearing Aid Reimbursement: A Discussion of Influencing Factors.

Reimbursement for hearing aids in the present time has become as complicated, if not more so, than any other area of health care. For many years, hearing aids were a noncovered item where insurance was concerned. The predominant model of bundling costs into a single dollar amount was copied decades ago from hearing instrument specialists. However, insurance companies and federal agencies are increasingly covering the cost of the diagnostic hearing evaluation and at least some of the costs associated with hearing aid purchases. One operational question is whether the bundled charge model is still appropriate, or should audiologists follow more closely the example of optometry whereby professional services are charged separately from the cost of goods sold? The models that have evolved constitute a broad mixture of bundling, partial bundling (i.e., partial unbundling), and complete unbundling. There exists no uniformity for which charge method is best. But, with greater frequency, insurance requirements are forcing a movement toward partial or complete unbundling of associated costs. Regardless of which charge model is adopted, calculation of the cost of service delivery for each audiology practice is an essential business component to justify charges and make educated decisions regarding participation in various insurance, cooperative, or network plans.

PERHITUNGAN PROFIT ASURANSI UNIT LINK DENGAN SURRENDER VALUE MENGGUNAKAN METODE PROFIT TESTING

Life insurance with surrender value is a type of insurance that allows the insured to cancel the contract. Unit-link life insurance is a combination of life insurance and investment. Profit testing method is used to find out the potensial loss or gain of unit link life insurance product. The aim of this research was to determine the potential benefits or losses of unit-linked life insurance product using a deterministic model. Results of this research are the profit obtained by the insurance company for an insurance participant aged 35 years with a sum and in annual premiums are

MEKANISME PENDISTRIBUSIAN SURPLUS UNDERWRITING DANA TABARRU’ PADA PT. ASURANSI TAKAFUL KELUARGA KANTOR SURABAYA

This study discusses the mechanism for distributing tabarru's underwriting funds surplus. The purpose of this study was to find out and understand the concept of the mechanism for distributing tabarru's underwriting funds' surplus at the Surabaya Office Family Takaful Insurance. In this study using a qualitative approach with descriptive case study strategies and data collection techniques in the form of interviews and documentation. The results in this study are the distribution mechanism at the underwriting surplus in accordance with the products used by participants and will be processed after the submission of profit sharing by filling out a form submitting the results of the results made by insurance participants.

Individual Market Volatility and Vulnerability, 2015 to 2019

The Affordable Care Act (ACA) introduced large changes to the individual market for health insurance. Using 2015–2019 HIX Compare and geographic-specific data, this study examines the volatility and vulnerability of local insurance markets using insurer participation and premium information. The study also examines how markets with higher volatility and vulnerability differ from others with respect to demographics, labor market conditions, health status, provider supply, and state policies. Entry and exit patterns suggest decreasing volatility, but forty-eight million Americans reside in markets that are vulnerable, given limited competition and high premiums.

Path Analysis on the Equity of Hemodialysis Utilization in the National Health Insurance Program in Jember, East Java

Background : Since 2014, Indonesia has implemented a National Health Insurance to cover pu­blic health costs. The existence of health insurance managed by the government is expected to help all levels of society to obtain health services. This is very helpful for the community, especially for pa­tients with chronic diseases who need continuous treatment. This study aims to analyze the fair­ness and determinants of the use of hemodialysis patients with chronic kidney failure in National He­alth Insurance participants in Jember Regency. Subject an d Met h od: This was observational analytic study with cross sectional approach, conducted at Dr. Soebandi Hospital and Kaliwates General Hospital, Jember, East Java. A total Study subjects of 200 patients with chronic kidney failure undergoing hemodialysis with JKN membership we­re selected for this study by purposive sampling. The dependent variable was the use of hemo­dia­lysis. The independent variables were JKN membership status, length of time since diagnosis, di­sease severity, age, education, family income, access to health facilities and residence. Data col­lec­tion used questionnaires and medical record documents and then analyzed using path analysis. Results : The possibility of using hemodialysis was increased by the Non PBI status (b= 0.81; 95% CI= 0.16 to 1.47; p= 0.015), high disease severity (b=2.48; 95% CI=0.36 to 4.59; p= 0.022), age ≥ 50 years old (b=0.65; 95% CI = 0.33 to 1.26; p= 0.039), family income ≥ MW (b= 0.59; 95% CI= -0.07 to 1.24; p= 0.080) and good access to health facility (b= 0.92; 95% CI= -0.19 to 1.66; p= 0.013). The possibility of using hemodialysis was indirectly affected by the length of time since diag­nosis, education and residence. Conclusions : The possibility of using hemodialysis was increased by Non PBI status, disease se­ve­rity, age, family income, and access to health facilities. The possibility of using hemodialysis was in­directly affected by the length of time since diagnosis, education, and residence. Keywords : National Health Insurance, justice, hemodialysis, path analysis Co r respondence : Siti Nafi’atus Salamah. Public Health Sciences Study Program, Universitas Sebelas Maret. Jl. Ir. Su­ta­mi 36 A, Surakarta 57126, Central Java. Email: sitinafiatus27@gmail.com. Mobile: 081289434401 Journal of Health Policy and Management (2020), 5(2): 108-120 https://doi.org/10.26911/thejhpm.2020.05.02.03

Medical insurance participation and the ageing population subjective well-being: an empirical analysis based on CGSS 2015 data

Using the Chinese General Social Survey (CGSS 2015) data, the current research is to examine the relationship between medical insurance and subjective well-being for elderly people in China. To test our hypothesis, we first generated and tested an ordered probit model, as the dependent variable in our research is subjective well-being, additionally, as in China we have different medical insurance types, we integrated them and classified them as social basic medical insurance, and commercial medical insurance. Also, as the causal identification problem and endogenous problem exist, we introduced another main dependent variable as the individual’s social security satisfaction in our research. The implications derived from this study are summarized as conclusions.

Gambaran Kepesertaan JKN Tahun 2019

National Health Insurance (JKN) is a program of the National Social Security System with the principle of social health insurance that is mandatory for the Indonesian population under Law No. 40 of 2004. The National Health Insurance has been implemented by the BPJS since January 1, 2014. BPJS of Health is a public legal entity that coordinates directly under the President and in 2019 all Indonesian people have to become JKN participants to make Universal Health Coverage (UHC). The purpose of this study was to study the JKN participant in 2019. This study used a descriptive type of research. The subject of this study is the all population of Indonesia. This study will discuss the number of JKN participants, types of JKN participation, rights and obligations, procedures for registration, cost, and how to use a National Health Insurance card. The results of this study show data from BPJS of Health on August 8, 2014 that National Health Insurance participants 126,487,166 people from total population 257,5 million. JKN participation continues to increase every year until 2019. Data from BPJS Health of JKN participants as of April 1, 2019 amounted to 219,669,453 people with a total PBI-APBN 96,517,386 people, PBI-APBD 35,925,726 people, PPU – PN 17,279,621 people, PPU-BU 33,187,465 people, PBPU 31,600,985 people, and Not Workers 5,158,270 people. In 2019 all Indonesia people became JKN participants. The conclusion that the number of JKN participants continued to increase, April 1, 2019 JKN participants 219.669.453 people from total population 257,5 million and in 2019 Indonesia be expected UHC. Suggestions this research, companies that have not yet register their employees in JKN and people have not yet become JKN participants are immediately register through the office / website BPJS of Health or care center 1500400, Mobile JKN, e-DABU.

Peranan Kepemimpinan dalam Menerapkan Prinsip-Prinsip Good Governance di Instansi Pemerintahan Daerah

An attempt to embody a quality, government officials clean and authoritative; the government has set some rules that must be implemented by all the elements government officials who serves as the man of the country and the man of the community. The performance of government agencies in the spotlight from various parties, especially since the reform movement demanding structural change in various fields. In short, today is going on a change from a bad administration pattern at the formation of a good administration. An effort to reach the level of efficiency work organization there needs to be improving performance. There are some things owned by the administration in creating good, so as to be assessed as being successful, his leadership among other: intelligence maturity you, social relations motivation and encouragement, performed sikap-sikap, humanitarian relationship oriented, duty and authority honest and open, demokrastis, and administrative participate and responsible. As for the principles of good governance at least some of the things that must be upheld and performed, namely: accountability, transparency, openness certainty hukum-legalitas, insurance participation, partnership, decentralization professional and proportionate, effective and efficient, productivity and quality of work.

Cost of Illness Diabetes Melitus Tipe 2 dan Komplikasinya pada Peserta Jaminan Kesehatan Nasional (JKN) di Rawat Jalan Rumah Sakit Condong Catur Yogyakarta

Type 2 diabetes mellitus is a chronic disease that requires lifelong therapy and high service costs so that the use of antidiabetic drugs affects the patient's therapeutic costs. The purpose of this study was to determine the cost of outpatient type 2 diabetes mellitus therapy for National Health Insurance (JKN) participants in Condong Catur Hospital Yogyakarta. The research method used is observational. The parameters measured are calculating the average direct medical costs (drug costs, doctor's examination and consultation fees, laboratory costs, medical treatment costs), and comparison between the costs of oral drugs, insulin, oral and insulin. The results of normality tests with Shapiro-Wilk (microvascular, microvascular and macrovascular), Kolmogorrov-Smirnov (macrovascular) p0.05 indicate that data are not normally distributed, the results of the Kruskal Wallis test of the three groups (microvascular, macrovascular, microvascular and microvascular) show that differences are not normally distributed significant (p = 0.001).The results showed that the microvascular group therapy costs Rp 3,164,733.58 per month, the macrovascular group Rp 9,984,566.85 per month, the microvascular and macrovascular groups Rp 11,260,372.39 per month. The cost of therapy is based on the microvascular group drug Rp. 408,567.78 per month, the macrovascular group Rp. 1,245,987.48 per month, the microvascular and macrovascular groups Rp. 1,786,270.68 per month so that statistically from the three complications groups show significant differences p = 0,001 (p 0,005). The difference in the difference between the total real costs and the total INA-CBG's rates, the microvascular group Rp -38,741.14 per patient, the macrovascular group Rp -10,914.03 per patient, while in the microvascular and macrovascular group Rp 3,272.90 per patient shows that from to three groups of complications were not significantly different p = 0.207 (p 0.005). Statistically it can be concluded that the cost of therapy based on antidiabetic drugs in the three groups of complications shows a significant difference. There is no significant difference in the difference between the real costs in the three groups of complications

Faktor-Faktor Yang Mempengaruhi Kepatuhan Pasien Dalam Mengkonsumsi Obat Antihipertensi Di Puskesmas Jatinom

Many degenerative diseases occur because of an unhealthy lifestyle. One type of degenerative disease is hypertension. Hypertension is a disease that requires long-term therapy, so it requires patient coverage in the treatment needed to control blood pressure and reduce the risk of complications. This study discusses the factors that influence the consideration of patients in taking antihypertensive drugs.This research is a descriptive analytic research with cross sectional design. The population of the study amounted to 1215 with an average of 101 hypertension visits a month. The number of samples taken was 50 respondents by accidental sampling. Measurement of compliance was carried out using the MMAS (Modified Morisky Adherence Scale) questionnaire.The results of this study can be concluded that the factors of sex, level of last education, employment status, duration of hypertension, insurance participation, level of knowledge, access to health services, family support, the role of health workers, and motivation for treatment, have no relationship with compliance in taking antihypertensive drug

Impact of voluntary community-based health insurance on child stunting: Evidence from rural Uganda

While community-based health insurance increasingly becomes part of the health financing landscape in developing countries, there is still limited research about its impacts on health outcomes. Using cross-sectional data from rural south-western Uganda, we apply a two-stage residual inclusion instrumental variables method to study the impact of insurance participation on child stunting in under-five children. We find that one year of a household's participation in community-based health insurance was associated with a 4.3 percentage point less probability of stunting. Children of two years or less dominated the effect but there were also statistically significant benefits of enrolling in insurance after a child's birth. The expansion of community-based health insurance might have more dividends to improving health, in addition to financial protection and service utilisation in rural developing countries.

Perceived importance of structural factors are associated with the selection of primary care by national health insurance participants

Background and purpose: Primary care are the entry point for health services in an insurance-based health financing system, including the National Health Insurance Program or Jaminan Kesehatan Nasional (JKN) in Indonesia. This study aims to understand the association between structural factors in health service management with primary care selection among JKN participants.
 Methods: The study used a cross sectional analytic design, conducted with 273 self-paid JKN participants in Denpasar as respondents. The samples were selected using multistage random sampling. Data was collected from April to May 2018 with interviews using a questionnaire covering the characteristics of respondents and perceptions on the importance of health care facilities, the capabilities of health providers, service distance, operational time, availability of drugs and medical equipment. Data analysis was carried out with multinomial logistic regression to determine the structural factors of health service management associated with the selection of primary care.
 Results: Most respondents (65.9%) chose private clinics, 21.3% chose public health centres (PHCs) and 12.8% chose individual practicing physicians. Multivariate analysis showed that the variables which significantly associated with the selection of primary care among JKN participants were the perceived importance of the health care facilities at PHCs and private clinics, each with AOR=7.83 (95%CI: 2.72–22.54) and AOR=7.18 (95%CI: 2.76–18.68), the perceived importance of the capability of health workers in private clinics with AOR=0.29 (95%CI: 0.12–0.77), the perceived importance of health service time in private clinics with AOR=2.67 (95%CI: 1.05–6.74) and history of health services utilization at private clinics with AOR=4.51 (95%CI: 1.86–10.96).
 Conclusion: Structural factors are associated with the selection of primary care among JKN participants. Attention to the quality and quantity of structural factors in the management of health services is important to improve the equitable distribution of JKN membership in the registered primary care.