From closure to care: tracing the path of service utilization following a health insurer shutdown

This study examines the impact of insurer congestion and quality on healthcare service utilization. We exploit the 2015 closure of one of Colombia’s largest insurers, which led to the reallocation of its members to various insurers within the same municipalities. Consequently, the receiving entities experienced a sudden and unexpected influx of new affiliates, leading to varying levels of pressure, or “congestion”. Using a difference-in-differences empirical strategy, we analyze changes in healthcare utilization among reallocated individuals before and after the liquidation.