577-2297
gail.jensen@wayne.edu
226 Knapp

Gail Jensen Summers is a jointly appointed professor in the Institute of Gerontology and Department of Economics. She received her Ph.D. in economics from the University of Minnesota in 1986, and has previously held positions at the University of Illinois at Chicago, the American Hospital Association, and Abt Associates, Inc.

Dr. Jensen Summers has authored over 75 articles in scholarly journals and books, and has often written on health economics and health insurance issues. She is a nationally recognized expert on employer-sponsored health insurance, the regulation of private health insurance, and on health insurance issues concerning older adults. Much of her research over the past 10 years has focused on the provision of group coverage, the effects of state health insurance regulation for employer plans, particularly its consequences for small businesses, and the effects of managed care.

Her research has appeared in the Review of Economics and Statistics, Journal of Health Economics, The Milbank Quarterly, Medical Care, and Health Affairs, among others. She currently serves on the National Advisory Council of the National Institute on Alcohol Abuse and Alcoholism, the Board of Directors of the Michigan Public Health Institute, and is a Fellow of both the Employee Benefit Research Institute in Washington, DC and of the National Center for Policy Analysis in Dallas, TX.

Research Focus

Health Insurance of the Near Elderly

The near-elderly, those aged 55 to 64, present a challenge to private health insurance because of their heterogeneous insurance needs. Many continue to be employed with active worker coverage. However, some older workers have been forced from the labor market and employer-sponsored health insurance due to declining health. Others have retired from one career and begun another and are faced with the prospect of purchasing insurance in the individual market. Still others have opted for early retirement and are transitioning to retiree coverage. The aging baby-boom generation means that this segment of the market will be rapidly growing over the next 20 years. This age group will increase by nearly 50 percent by 2010 and will comprise 13 percent of the U.S. resident population by 2020.

Using data from the ongoing Health and Retirement Survey, Professor Jensen Summers is studying trends in health insurance among the near-elderly. This work encompasses both active-worker and retiree coverage offered by employers, individually purchased health insurance, public coverage, as well as the lack of coverage within this age cohort. A particular focus of her research is the growing presence of managed care and its implications for the near-elderly as they transition into retirement and/or onto Medicare.

Dr. Jensen Summers maintains that the near-elderly may hold the key to Medicare reform. Her work suggests that managed care options under Medicare may be attractive choices to a sizable component of the aging baby-boom generation, and this bodes well for the debates on Medicare reform that will emerge in the next few years. Policymakers should have some real flexibility to consider a wider range of options, and may not be limited to simply tinkering with the existing system. Proposals that involve a substantial role for managed care plans may be much more acceptable to baby-boomers, because of their widespread experience with these plans. However, the number of near-elders who, even today, remain in traditional fee-for-service suggests that acceptable reforms will likely need to accommodate a range of preferences among seniors.


Evolution of Self-Insurance in an Era of Managed Care

Covering more than 80 million active workers and their dependents as well as 8 million retirees, employers’ self-insured health plans remain America’s principal bearer for the financial risks of illness. With self-insurance, an employer (or union) assumes all or part of the risk for paying claims submitted under the plan. This contrasts with purchased insurance, where an employer pays an insurance premium to an insurance company or managed care organization, and the latter is liable for paying claims.

Critics of self-insurance cite concerns with this financial arrangement. One concern is the issue of fairness in regulation. There are two separate and unequal regulatory systems in this country: one for self-insured plans and another for purchased plans. Persons covered through self-insured plans lack the same consumer protection laws that persons covered through purchased plans have, e.g., laws that safeguard against plan insolvency, fraudulent plan behavior, and refusal to pay for treatments and services promised by the employer.

Previous research on self-insured health plans has been limited to conventional fee-for-service (FFS) plans. This is because up until recently, self-insurance was largely a FFS plan phenomenon. The 1990s, however, saw a dramatic increase in the proportion of employers self-insuring managed care plans.

With funding from the Robert Wood Johnson Foundation, Dr. Jensen Summers has studied trends in self-insurance, including the changing content of coverage in these plans and how they compare to purchased plans. She is currently analyzing the determinants of employer decisions to pursue this funding mechanism for their health benefits.

Publications

Selected Publications (2000-present):

Touchette, Daniel R., Jensen, Gail A., and James Stevenson. (In press.) Cost-Effectiveness Analysis of Amifostine in Patients with Non-Small Cell Lung Cancer. Journal of Aging and Pharacotherapy.

Cramer, Anne and Jensen, Gail A. (In press.) Why Don’t People Buy Long Term Care Insurance? Journal of Gerontology: Social Sciences.

Xu, Xiao and Jensen, Gail A. (2005). Utilization of Health Care Services Among the Near-Elderly: A Comparison of Managed Care and Fee-for-Service Enrollees, Managed Care Interface, 18(3): 60-66.

Xu, Xiao, Jensen, Gail A., and Ransom, Scott B. (2005). Patients with Diabetes Enrolled in Medicare HMOs More Likely to Use Oral Medications. Drug Benefit Trends, 17(7): 298-305.

Jensen, Gail A. and Morrisey, Michael A. (2004). Are Healthier Older Adults Choosing Managed Care? The Gerontologist, 44(1): 85-94.

Morrisey, Michael A., Jensen, Gail A., and Gabel, Jon R. (2003). Managed Care and Employer Premiums. International Journal of Health Care Finance and Economics, 3(2): 95-116.

Jensen, Gail A. (2003). Post-Retirement Health Insurance. In L.A. Vitt (ed.), Encyclopedia of Retirement and Finance, 620-624. Westport, CT: Greenwood Press.

Jensen, Gail A., Zhou, Zhiyuan, and Torigo, Yasuhiro (2003). Medical Care of Overactive Bladder in Elderly Patients, Journal of Aging and Pharmacotherapy, 13(1): 13-28.

Gabel, Jon R., Jensen, Gail A., and Hawkins, Samantha (2003). Self-Insurance in Eras of Growing and Retreating Managed Care. Health Affairs, 22(2): 202-210.

Jensen, Gail A. (2002). Make People More Sensitive to Health Prices. The Detroit News, June 10, p. 9A.

Jensen, Gail A. and Morrisey, Michael A. (2001). Endogenous Fringe Benefits, Compensating Wage Differentials, and Older Workers. International Journal of Health Care Finance and Economics, 1(2): 203-226.

Zhou, Zhiyuan, Jensen, Gail A., Barr, Charles E., and Torigo, Yasuhiro (2001). Antidepressant Use and Treatment of Overactive Bladder Disorder. Drug Benefit Trends, 13(12): 7-16.

Morrisey, Michael A. and Jensen, Gail A. (2001). The Near-Elderly, Early Retirees and Managed Care. Health Affairs, 20(6): 197-206.

Zhou, Zhiyuan and Jensen, Gail A. (2001). Insurance Claims Costs for Overactive Bladder Disorder. Drug Benefit Trends, 13(4): 45-58.

Jensen, Gail A. (2000). Economics of the Physician Marketplace. In Ransom, S.B., Pinsky, W., and Tropman, J. (eds.), Enhancing Physician Performance, pp. 413-428. Tampa, FL: American College of Physician Executives.

Jensen, Gail A. (2000). New Health Fiats Portend More Uninsured. The Detroit News, September 25, p. A7.

Jensen, Gail A. (2000). Making Room for Medical Savings Accounts. In Roger Feldman (ed.), American Health Care: Government, Market Processes and the Public Interest, pp. 119-144. Oakland, CA: The Independent Institute/Transactions Publishers.

Jensen, Gail A. and Goodman, Allen C. (2000). The Economics of Obstetrics and Gynocology. In Ransom, S.B., Dombrowski, M.P., McNeeley, S.G., Moghissi, K.S., and Munkarah, A.R. (eds.), Practical Strategies in Obstetrics and Gynecology, pp. 719-733. New York, NY: W.B. Saunders.