Using a game-theoretic approach to design optimal health insurance for chronic disease

References

• Alagoz, O., Maillart, L. M., Schaefer, A. J., and Roberts, M. S. (2004) The optimal timing of living-donor liver transplantation. Management Science, 50, 1420–1430.
   Web of Science ®Google Scholar
• Arrow, K. J. (1963) Uncertainty and the welfare economics of medical care. The American Economic Review, 53, 941–973.
   Web of Science ®Google Scholar
• Arrow, K. J. (1976) Welfare analysis of changes in health coinsurance rates. In The Role of Health Insurance in the Health Services Sector (pp. 1–34). NBER, New York, NY.
   Google Scholar
• Betancourt, J. R., Green, A. R., Carrillo, J. E., et al. (2002) Cultural Competence in Health Care: Emerging Frameworks and Practical Approaches, volume 576. Commonwealth Fund, Quality of Care for Underserved Populations, New York, NY.
   Google Scholar
• Briesacher, B. A., Gurwitz, J. H., and Soumerai, S. B. (2007) Patients at-risk for cost-related medication nonadherence: A review of the literature. Journal of General Internal Medicine, 22, 864–871.
   PubMed Web of Science ®Google Scholar
• Brook, R. H., Ware, J. E., Rogers, W. H., Keeler, E. B., Davies, A. R., Sherbourne, C. D., Goldberg, G. A., Lohr, K., Camp, P., and Newhouse, J. P. (1984) The effect of coinsurance on the health of adults: Results from the RAND Health Insurance Experiment, Report R-3055-HHS, Santa Monica, CA.
   Google Scholar
• Brunström, M., and Carlberg, B. (2016) Effect of antihypertensive treatment at different blood pressure levels in patients with diabetes mellitus: Systematic review and meta-analyses. British Medical Journal, 352, i717.
   PubMed Web of Science ®Google Scholar
• Cardiovascular Business. (2017) Treating uncontrolled hypertension makes dollars and sense. http://www.cardiovascularbusiness.com/topics/healthcare-economics/treating-uncontrolled-hypertension-makes-dollars-and-sense (accessed August 28, 2017).
   Google Scholar
• Centers for Disease Control and Prevention (CDC). (2012) Vital signs: Awareness and treatment of uncontrolled hypertension among adults–United States, 2003-2010. Morbidity and Mortality Weekly Report, 61, 703.
   PubMedGoogle Scholar
• Centers for Disease Control and Prevention (CDC). (2015) High blood pressure facts. http://www.cdc.gov/bloodpressure/facts.htm/ (accessed August 28, 2017).
   Google Scholar
• Chang, T.-S., and Ho, Y.-C. (1981) Incentive problems: A class of stochastic stackelberg closed-loop dynamic games. Systems & Control Letters, 1, 16–21.
   Web of Science ®Google Scholar
• Chang, T.-S., and Ho, Y.-C. (1983) Stochastic Stackelberg games: Nonnested multistage multiagent incentive problems. IEEE Transactions on Automatic Control, 28, 477–488.
   Web of Science ®Google Scholar
• Chao, L.-W. (2002) A comparison of consensus and nonconsensus approaches to modeling contraceptive choice behavior. Health Economics, 11, 599–622.
   Web of Science ®Google Scholar
• Chen, B., and Fan, V. Y. (2015) Strategic provider behavior under global budget payment with price adjustment in Taiwan. Health Economics, 24, 1422–1436.
   PubMed Web of Science ®Google Scholar
• Chernew, M. E., Rosen, A. B., and Fendrick, A. M. (2007) Value-based insurance design. Health Aff (Millwood), 26, w195–w203.
   Web of Science ®Google Scholar
• Chobanian, A. V., Bakris, G. L., Black, H. R., Cushman, W. C., Green, L. A., Izzo, J. L., Jones, D. W., Materson, B. J., Oparil, S., Wright, J. T., Roccella, E. J., and the National High Blood Pressure Education Program Coordinating Committee (2003) Seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension, 42, 1206–1252.
   PubMed Web of Science ®Google Scholar
• Christian-Herman, J., Emons, M., and George, D. (2004) Effects of generic-only drug coverage in a Medicare HMO. Health Affairs, 23, W4.
   Web of Science ®Google Scholar
• Conitzer, V., and Sandholm, T. (2006) Computing the optimal strategy to commit to. In Proceedings of the 7th ACM Conference on Electronic Commerce, 82–90.
   Google Scholar
• CostHelper (2017) High blood pressure treatment cost. http://health.costhelper.com/treating-high-blood-pressure-cost.html (accessed August 28, 2017).
   Google Scholar
• Cutler, D. M., and Zeckhauser, R. J. (2000) The anatomy of health insurance. Handbook of Health Economics, 1, 563–643.
   Google Scholar
• Delle Fave, F. M., Jiang, A. X., Yin, Z., Zhang, C., Tambe, M., Kraus, S., and Sullivan, J. P. (2014) Game-theoretic patrolling with dynamic execution uncertainty and a case study on a real transit system. Journal of Artificial Intelligence Research, 50, 321–367.
   Web of Science ®Google Scholar
• Doiron, D., Jones, G., and Savage, E. (2008) Healthy, wealthy and insured? The role of self-assessed health in the demand for private health insurance. Health Economics, 17, 317–334.
   PubMed Web of Science ®Google Scholar
• Eaddy, M. T., Cook, C. L., O’Day, K., Burch, S. P., and Cantrell, C. R. (2012) How patient cost-sharing trends affect adherence and outcomes: A literature review. Pharmacy and Therapeutics, 37, 45.
   Google Scholar
• Elliott, W. J. (2003) The economic impact of hypertension. The Journal of Clinical Hypertension (Greenwich), 5, 3–13.
   PubMedGoogle Scholar
• Ellis, R. P., Jiang, S., and Manning, W. G. (2015) Optimal health insurance for multiple goods and time periods. Journal of Health Economics, 41, 89–106.
   Web of Science ®Google Scholar
• Ellis, R. P., and Manning, W. G. (2007) Optimal health insurance for prevention and treatment. Journal of Health Economics, 26, 1128–1150.
   Web of Science ®Google Scholar
• Emanuel, E. J., and Fuchs, V. R. (2008) The perfect storm of overutilization. Journal of the American Medical Association, 299, 2789–2791.
   PubMed Web of Science ®Google Scholar
• Epstein, B. J. (2010) Improving blood pressure control rates by optimizing combination antihypertensive therapy. Expert Opinion on Pharmacotherapy, 11, 2011–2026.
   PubMed Web of Science ®Google Scholar
• Fishman, P. A., Ding, V., Hubbard, R., Ludman, E. J., Pabiniak, C., Stewart, C., Morales, L., and Simon, G. E. (2012) Impact of deductibles on initiation and continuation of psychotherapy for treatment of depression. Health Services Research, 47, 1561–1579.
   Web of Science ®Google Scholar
• Ganzfried, S., and Sandholm, T. (2010) Computing equilibria by incorporating qualitative models? In Proceedings of the 9th International Conference on Autonomous Agents and Multiagent Systems: Volume 1, 183–190.
   Google Scholar
• Goldman, D., and Philipson, T. (2007) Integrated Insurance Design in the Presence of Multiple Medical Technologies. American Economic Review, 97, 427–432.
   Google Scholar
• Goldman, D. P., Joyce, G. F., and Zheng, Y. (2007) Prescription drug cost sharing: Associations with medication and medical utilization and spending and health. Journal of the American Medical Association, 298, 61–69.
   PubMed Web of Science ®Google Scholar
• Goodell, S., and Swartz, K. (2010) Cost-sharing: Effects on spending and outcomes. Policy Brief, 20, 42–45.
   Google Scholar
• Hoadley, J. (2005) Cost Containment Strategies for Prescription Drugs: Assessing the Evidence in the Literature. Henry H. Kaiser Family Foundation, Menlo Park, CA.
   Google Scholar
• Hu, C., Lovejoy, W. S., and Shafer, S. L. (1996) Comparison of some suboptimal control policies in medical drug therapy. Operations Research, 44, 696–709.
   Web of Science ®Google Scholar
• Huskamp, H. A., Deverka, P. A., Epstein, A. M., Epstein, R. S., McGuigan, K. A., and Frank, R. G. (2003) The effect of incentive-based formularies on prescription-drug utilization and spending. New England Journal of Medicine, 349, 2224–2232.
   PubMed Web of Science ®Google Scholar
• Huskamp, H. A., Deverka, P. A., Epstein, A. M., Epstein, R. S., McGuigan, K. A., Muriel, A. C., and Frank, R. G. (2005) Impact of 3-tier formularies on drug treatment of attention-deficit/hyperactivity disorder in children. Archives of General Psychiatry, 62, 435–441.
   Google Scholar
• Joffres, M., Falaschetti, E., Gillespie, C., Robitaille, C., Loustalot, F., Poulter, N., McAlister, F. A., Johansen, H., Baclic, O., and Campbell, N. (2013) Hypertension prevalence, awareness, treatment and control in national surveys from England, the USA and Canada, and correlation with stroke and ischaemic heart disease mortality: A cross-sectional study. British Medical Journal, 3, e003423.
   PubMed Web of Science ®Google Scholar
• Lakić, D., Petrova, G., Bogavac-Stanojević, N., Jelić-Ivanović, Z., and Kos, M. (2012) The cost-effectiveness of hypertension pharmacotherapy in Serbia: A Markov model. Biotechnology & Biotechnological Equipment, 26, 3066–3072.
   Web of Science ®Google Scholar
• Lee, C. P., Chertow, G. M., and Zenios, S. A. (2008) Optimal initiation and management of dialysis therapy. Operations Research, 56, 1428–1449.
   Web of Science ®Google Scholar
• Lefévre, C. (1981) Optimal control of a birth and death epidemic process. Operations Research, 29, 971–982.
   PubMed Web of Science ®Google Scholar
• Letchford, J., MacDermed, L., Conitzer, V., Parr, R., and Isbell, C. L. (2012) Computing optimal strategies to commit to in stochastic games. In Processing of Twenty-Sixth National Conference on Artificial Intelligence, Toronto, ON, Canada.
   Google Scholar
• Liu, X., Nestic, D., and Vukina, T. (2012) Estimating adverse selection and moral hazard effects with hospital invoices data in a government-controlled healthcare system. Health Economics, 21, 883–901.
   Web of Science ®Google Scholar
• Lovibond, K., Jowett, S., Barton, P., Caulfield, M., Heneghan, C., Hobbs, F. R., Hodgkinson, J., Mant, J., Martin, U., Williams, B.,Wonderling, D., and McManus, R. J. (2011) Cost-effectiveness of options for the diagnosis of high blood pressure in primary care: A modelling study. The Lancet, 378, 1219–1230.
   PubMed Web of Science ®Google Scholar
• Ma, C. Y., Yau, D. K., Lou, X., and Rao, N. S. (2013) Markov game analysis for attack-defense of power networks under possible misinformation. IEEE Transactions on Power Systems, 28, 1676–1686.
   Web of Science ®Google Scholar
• Mann, B. S., Barnieh, L., Tang, K., Campbell, D. J., Clement, F., Hemmelgarn, B., Tonelli, M., Lorenzetti, D., and Manns, B. J. (2014) Association between drug insurance cost sharing strategies and outcomes in patients with chronic diseases: A systematic review. PLoS One, 9, e89168.
   PubMed Web of Science ®Google Scholar
• McCormick, G. P. (1976) Computability of global solutions to factorable nonconvex programs: Part I – Convex underestimating problems. Mathematical Programming, 10, 147–175.
   Web of Science ®Google Scholar
• Mojtabai, R., and Olfson, M. (2003) Medication costs, adherence, and health outcomes among medicare beneficiaries. Health Affairs, 22, 220–229.
   PubMed Web of Science ®Google Scholar
• Moran, A. E., Odden, M. C., Thanataveerat, A., Tzong, K. Y., Rasmussen, P. W., Guzman, D., Williams, L., Bibbins-Domingo, K., Coxson, P. G., and Goldman, L. (2015) Cost-effectiveness of hypertension therapy according to 2014 guidelines. New England Journal of Medicine, 372, 447–455.
   PubMed Web of Science ®Google Scholar
• National Center for Health Statistics (US) (2016) Health, United States, 2015: With special feature on racial and ethnic health disparities. http://www.cdc.gov/nchs/data/hus/hus15.pdf (accessed May 7, 2018).
   Google Scholar
• Nguyen, C. V. (2012) The impact of voluntary health insurance on health care utilization and out-of-pocket payments: New evidence for Vietnam. Health Economics, 21, 946–966.
   PubMed Web of Science ®Google Scholar
• Nisan, N., Roughgarden, T., Tardos, E., and Vazirani, V. V. (2007) Algorithmic Game Theory volume 1. Cambridge University Press, Cambridge, England.
   Google Scholar
• Ostchega, Y., Yoon, S. S., Hughes, J., and Louis, T. (2008). Hypertension awareness, treatment, and control–Continued disparities in adults: United States, 2005-2006. NCHS Data Brief, 1–8.
   Google Scholar
• Pauly, M. V., and Blavin, F. E. (2008) Moral hazard in insurance, value-based cost sharing, and the benefits of blissful ignorance. Journal of Health Economics, 27, 1407–1417.
   Web of Science ®Google Scholar
• Pita, J., Jain, M., Ordónez, F., Portway, C., Tambe, M., Western, C., Paruchuri, P., and Kraus, S. (2009) Using game theory for Los Angeles airport security. AI Magazine, 30, 43.
   Web of Science ®Google Scholar
• Prospective Studies Collaboration (2002) Age-specific relevance of usual blood pressure to vascular mortality: A meta-analysis of individual data for one million adults in 61 prospective studies. The Lancet, 360, 1903–1913.
   PubMed Web of Science ®Google Scholar
• Puterman, M. L. (2014) Markov Decision Processes: Discrete Stochastic Dynamic Programming. John Wiley & Sons, Hoboken, NJ.
   Google Scholar
• Rothschild, M., and Stiglitz, J. (1976) Equilibrium in competitive insurance markets: An essay on the economics of imperfect information. Quarterly Journal of Economic, 90, 629–649.
   Google Scholar
• Schaefer, A. J., Bailey, M. D., Shechter, S. M., and Roberts, M. S. (2005) Modeling medical treatment using Markov decision processes. In Operations Research and Health Care: A Handbook of Methods and Applications (pp. 593–612). Kluwer Academic Publishers, Boston, MA.
   Google Scholar
• Shechter, S. M., Bailey, M. D., Schaefer, A. J., and Roberts, M. S. (2008) The optimal time to initiate HIV therapy under ordered health states. Operations Research, 56, 20–33.
   Web of Science ®Google Scholar
• Shrank, W. H., Hoang, T., Ettner, S. L., Glassman, P. A., Nair, K., DeLapp, D., Dirstine, J., Avorn, J., and Asch, S. M. (2006) The implications of choice: Prescribing generic or preferred pharmaceuticals improves medication adherence for chronic conditions. Archives of Internal Medicine, 166, 332–337.
   PubMed Web of Science ®Google Scholar
• Shrank, W. H., Young, H. N., Ettner, S. L., Glassman, P., Asch, S. M., and Kravitz, R. L. (2005) Do the incentives in 3-tier pharmaceutical benefit plans operate as intended? Results from a physician leadership survey. American Journal of Managed Care, 11, 16–22.
   PubMed Web of Science ®Google Scholar
• Sinnott, S.-J., Buckley, C., David, O., Bradley, C., Whelton, H.(2013) The effect of copayments for prescriptions on adherence to prescription medicines in publicly insured populations: A systematic review and meta-analysis. PLoS One, 8, e64914.
   PubMed Web of Science ®Google Scholar
• Sonnenberg, F. A., and Beck, J. R. (1993) Markov models in medical decision making: A practical guide. Medical Decision Making, 13, 322–338.
   PubMed Web of Science ®Google Scholar
• Steimle, L. N., and Denton, B. T. (2017) Markov decision processes for screening and treatment of chronic diseases. In Markov Decision Processes in Practice (pp. 189–222). Springer, New York, NY.
   Google Scholar
• Su, X., and Zenios, S. (2004) Patient choice in kidney allocation: The role of the queueing discipline. Manufacturing & Service Operations Management, 6, 280–301.
   Google Scholar
• Taira, D. A., Wong, K. S., Frech-Tamas, F., and Chung, R. S. (2006) Copayment level and compliance with antihypertensive medication: Analysis and policy implications for managed care. American Journal of Managed Care, 12, 678–684.
   PubMed Web of Science ®Google Scholar
• Thomas, C. P. (2008) How Prescription Drug Use Affects Health Care Utilization and Spending by Older Americans: A Review of the Literature. Public Policy Institute, Waltham, MA.
   Google Scholar
• Ugajin, T., Hozawa, A., Ohkubo, T., Asayama, K., Kikuya, M., Obara, T., Metoki, H., Hoshi, H., Hashimoto, J., Totsune, K., Satoh, H., Tsuji, I., and Imai, Y. (2005) White-coat hypertension as a risk factor for the development of home hypertension: The Ohasama study. Archives of Internal Medicine, 165, 1541–1546.
   PubMed Web of Science ®Google Scholar
• US Census Bureau (2016) Selected characteristics of people 15 years and over, by total money income, work experience, race, Hispanic origin, and sex. http://www.census.gov/data/tables/time-series/demo/income-poverty/cps-pinc/pinc-01.html/ (accessed August 28, 2017).
   Google Scholar
• Vasudeva, E., Moise, N., Huang, C., Mason, A., Penko, J., Goldman, L., Coxson, P. G., Bibbins-Domingo, K., and Moran, A. E. (2016) Comparative cost-effectiveness of hypertension treatment in non-Hispanic Blacks and Whites according to 2014 guidelines: A modeling study. American Journal of Hypertension, 29, 1195–1205.
   Web of Science ®Google Scholar
• Vorobeychik, Y., and Singh, S. P. (2012) Computing Stackelberg equilibria in discounted stochastic games. In Processing of Twenty-Sixth National Conference on Artificial Intelligence. Toronto, ON, Canada.
   Google Scholar
• Wagner, S., Toftegaard, T. S., and Bertelsen, O. W. (2012) Challenges in blood pressure self-measurement. International Journal of Telemedicine and Applications, 2012, 2.
   Google Scholar
• Wilson, I. B., Rogers, W. H., Chang, H., and Safran, D. G. (2005) Cost-related skipping of medications and other treatments among Medicare beneficiaries between 1998 and 2000. Journal of General Internal Medicine, 20, 715–720.
   PubMed Web of Science ®Google Scholar
• Xie, B., Dilts, D. M., and Shor, M. (2006) The physician–patient relationship: The impact of patient-obtained medical information. Health Economics, 15, 813–833.
   Web of Science ®Google Scholar
• Zhu, Z. (2012) Optimal Financing Structure Mechanism Design for Healthcare Insurance. Ph.D. thesis, Purdue University.
   Google Scholar
• Zweifel, P., and Manning, W. G. (2000) Moral hazard and consumer incentives in health care. In Handbook of Health Economics, volume 1 (pp. 409–459). Elsevier, Netherlands.
   Google Scholar