Health Insurance, Fourth Edition

Instructor Resources:
Transition guide, test bank, slide decks, discussion guides for the end-of-chapter questions.

Where Policy Meets Practice: Unpacking the Economics of Health Insurance Coverage

The fourth edition of Health Insurance offers a timely and thorough exploration of the U.S. health insurance system through the lens of economic analysis, making complex topics both accessible and applicable for graduate students and healthcare professionals alike. Written from an outsider's perspective, the text moves beyond day-to-day operations to uncover the strategic forces shaping insurance markets and their implications for management and policy.

Grounded in core economic principles, this new edition preserves much of the foundational content in previous editions while providing expanded and updated coverage of key topics, including adverse selection, moral hazard, risk adjustment, underwriting, and utilization management. It also features a substantially revised discussion of provider consolidation, vertical integration, and cross-market mergers, alongside new content on administrative services only (ASO) contracts, level-funded plans, and pharmacy benefit management.

Other key updates include:

• A new chapter on insurance market structure.
• A new chapter on contemporary regulatory issues such as surprise billing, price transparency, and tiered networks.
• Expanded discussions on Medicare Advantage, retiree coverage, and Medicaid post-COVID-19.
• Integration of recent legislation and updated data and exhibits across all chapters.

Designed for both faculty and students interested in health economics, managed care, and health policy, Health Insurance, Fourth Edition, balances theory and real-world application to assist readers in thinking strategically about how insurance influences healthcare delivery and financing today.