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Hybrid Risk Adjustment for Pharmaceutical Benefits

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Author Info
Manuel García-Goñi
Pere Ibern ()
José María Inoriza
Abstract

This paper analyses the application of hybrid risk adjustment versus either prospective or concurrent risk adjustment formulae in the context of funding pharmaceutical benefits for the population of an integrated healthcare delivery organization in Catalonia during years 2002 and 2003. We apply a mixed formula and find that a hybrid risk adjustment model increases incentives for efficiency in the provision of low risk individuals at health organizations not only as a whole but also at each internal department compared to only prospective models by reducing within-group variation of drug expenditures.

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File URL: http://www.econ.upf.edu/docs/papers/downloads/1139.pdf
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Publisher Info
Paper provided by Department of Economics and Business, Universitat Pompeu Fabra in its series Economics Working Papers with number 1139.

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Date of creation: Jan 2009
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Handle: RePEc:upf:upfgen:1139

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Web page: http://www.econ.upf.edu/

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Related research
Keywords: Drug expenditure; hybrid risk-adjustment; morbidity; clinical risk groups;

Find related papers by JEL classification:
I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
  1. Kathryn Antioch & Randall Ellis & Steve Gillett & Daniel Borovnicar & Ric Marshall, 2007. "Risk adjustment policy options for casemix funding: international lessons in financing reform," The European Journal of Health Economics, Springer, vol. 8(3), pages 195-212, September. [Downloadable!] (restricted)
  2. Schokkaert, Erik & Van de Voorde, Carine, 2003. "Belgium: risk adjustment and financial responsibility in a centralised system," Health Policy, Elsevier, vol. 65(1), pages 5-19, July. [Downloadable!] (restricted)
  3. Keeler, Emmett B. & Carter, Grace M. & Trude, Sally, 1988. "Insurance aspects of DRG outlier payments," Journal of Health Economics, Elsevier, vol. 7(3), pages 193-214, September. [Downloadable!] (restricted)
  4. Van de ven, Wynand P.M.M. & Ellis, Randall P., 2000. "Risk adjustment in competitive health plan markets," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 14, pages 755-845 Elsevier. [Downloadable!] (restricted)
  5. Joseph P. Newhouse, 1996. "Reimbursing Health Plans and Health Providers: Efficiency in Production versus Selection," Journal of Economic Literature, American Economic Association, vol. 34(3), pages 1236-1263, September. [Downloadable!] (restricted)
  6. David M. Cutler & Mary Beth Landrum & Kate A. Stewart, 2006. "Intensive Medical Care and Cardiovascular Disease Disability Reductions," NBER Working Papers 12184, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
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This page was last updated on 2009-11-27.

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