Risk Adjustment Schemes in Social Health Insurance: Adjusting for Cost Differences Between Insurance Plans
A risk adjustment scheme (RAS) within social health insurance is designed to prevent insurers from engaging in risk selection. This paper shows that with cost differences between insurance plans as they exist between managed-care and traditional insurance, current RASs create incentives for insurers to use risk adjusters for selecting risk types. We investigate on an alternative RAS, which ties transfers to the average cost levels of plans. This alternative RAS is shown not to induce risk selection; a welfare analysis however reveals that a corresponding reform will generally not result in a welfare gain.
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Volume (Year): 61 (2006)
Issue (Month): 4 (February)
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References listed on IDEAS
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- Pauly, Mark V., 1984. "Is cream-skimming a problem for the competitive medical market?," Journal of Health Economics, Elsevier, vol. 3(1), pages 87-95, April.
- 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.
- Thomas G. McGuire & Jacob Glazer, 2000. "Optimal Risk Adjustment in Markets with Adverse Selection: An Application to Managed Care," American Economic Review, American Economic Association, vol. 90(4), pages 1055-1071, September.
- Glazer, Jacob & McGuire, Thomas G., 2002. "Setting health plan premiums to ensure efficient quality in health care: minimum variance optimal risk adjustment," Journal of Public Economics, Elsevier, vol. 84(2), pages 153-173, May.
- Kifmann, Mathias, 2002. "Community rating in health insurance and different benefit packages," Journal of Health Economics, Elsevier, vol. 21(5), pages 719-737, September.
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