In this Faculty Focus, Natalia Serna tells us about her current research.
I am an economist with an interest in health economics and industrial organization. My research agenda broadly examines the impact of government policies and insurance market structure on access to care through hospital networks, health outcomes, and healthcare costs. Specifically, my research shows that health insurers engage in risk selection by providing narrow hospital networks in services that mostly sick individuals tend to claim. While a market regulator would choose complete hospital networks to maximize enrollee surplus, implementing network adequacy rules requiring complete networks is costly for health systems. Instead, I show that strong competition between private insurers is needed to achieve appropriate access to health services relative to an insurer monopolist. These findings suggest that insurance and hospital market structure may have an impact on patient health outcomes through their effect on access to care. My more recent research therefore focuses on quantifying (i) the causal effect of hospital network breadth on patient mortality, (ii) the impact of payment contracts between insurers and hospitals on medical treatment decisions, and (iii) the potential deadweight loss associated with price regulation of prescription and over-the-counter medications. I explore these questions in the context of the Colombian healthcare system, which may provide insights relevant for addressing global development issues in low-middle income countries.
What ignited your passion for health policy?
My passion for health policy started when I learned about the multiple market failures in health insurance markets during my undergraduate and graduate courses. I recognized competition between health insurers and hospitals can affect patient health, which led me to combine my training in industrial organization with my interest in health economics. I believe that the design of health insurance markets, cost-sharing policies, and government regulation can have direct effects on how health care is provided to individuals with poor health status — those who need it the most. I also believe that health policy research has more tangible effects on policymaking, and isn’t that what research should be about?
Tell us about a few of your interests outside of academia and research.
I am interested in art, wildlife, and talking walks.