UMD Theses and Dissertations

Permanent URI for this collectionhttp://hdl.handle.net/1903/3

New submissions to the thesis/dissertation collections are added automatically as they are received from the Graduate School. Currently, the Graduate School deposits all theses and dissertations from a given semester after the official graduation date. This means that there may be up to a 4 month delay in the appearance of a given thesis/dissertation in DRUM.

More information is available at Theses and Dissertations at University of Maryland Libraries.

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    Essays on Health Care Satisfaction, Health Insurance, and Cancer Screening Among Veterans
    (2021) Frost, Sydney; Chen, Jie; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    Objective: to determine differences in satisfaction of health care services among veterans based on insurance type/coverage and the impact of service utilization of cancer screening services among female veterans who have received health care services within past 12 months. Methods: IPUMS National Health Interview Survey (NHIS) for the years 2013-2018 were used and logistic regressions applied. Results: veterans with VA-only coverage are significantly more dissatisfied with the services they receive compared to veterans who have any-private coverage. Conclusion: there are differences between satisfaction of care among veterans based on insurance type, but differences do not impact cancer screening utilization among female veterans who utilized health care services within the past 12 months. Future work: findings could be utilized to determine ways to increase satisfaction of care received among veterans within the VA, or drive policy creation to allow veterans to access health care services at non-VA facilities.
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    THE EFFECT OF OWN RACE/ETHNICITY DENSITY ON INSURANCE TAKE-UP BY ASIAN AMERICANS
    (2019) Choi, Yoon Sun; Roby, Dylan H; Health Services Administration; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    Asian Americans are the fastest growing minority population in the U.S. (Lopez et al., 2017). Since the implementation of the Patient Protection and Affordable Care Act (ACA), Asian Americans have benefitted from insurance coverage increases but continue to experience disparities at the subgroup level (Park et al., 2018). This study investigates the association of own race subgroup density on the take-up of insurance by examining the effect of Asian subgroup concentration that may provide social and knowledge support linkages to available insurance coverage options.
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    The Impact of Employer Premium Contribution Schemes on the Supply and Demand of Health Insurance
    (2013) Liu, Yiyan; Jin, Ginger Z; Economics; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    This dissertation consists of three essays on health insurance markets, analyzing the impact of employer premium contribution schemes on both the supply and demand sides of the market. The first two essays focus on the supply side, whereas the third essay looks at the demand side. In the first essay, I present an analytical framework to illustrate the effect of employer premium contribution schemes on health plan pricing. I model the employer-sponsored health insurance market as a differentiated-product oligopoly and study the pricing strategies of insurance plans before and after a policy change in employer premium contribution. I find that the employer premium contribution scheme has a differential impact on health plan pricing based on two market incentives: 1) consumers are less price sensitive when they only need to pay part of the premium increase, and 2) each health plan has an incentive to increase the employer's premium contribution to that plan. In the second essay, I confirm the theoretical predictions using 1991-2011 data before and after a premium contribution policy change that occurred in 1999 in the Federal Employees Health Benefits (FEHB) Program. Empirical results suggest that both market incentives mentioned above contribute to premium growth. Furthermore, I perform counterfactual analysis to show that average premium would have been 10% less than observed had the subsidy policy change not occurred in the FEHB program, and the federal government would have incurred 15% less in premium contribution. The third essay looks at how capped employer premium subsidies affect the level of adverse selection among consumers. Previous research suggests that the employer premium contribution scheme can exacerbate or mitigate the level of adverse selection among consumers. Using longitudinal health plan enrollment records of federal civilian employees from years 1997-2000, I present empirical results supporting previous theoretical as well as cross-sectional empirical evidence on the dampening effect of a higher employer premium subsidy cap on adverse selection. The overall level of adverse selection, approximated by the different premium levels enrollees select based on their age, does not change significantly over time in the FEHB program.