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risk adjustment

Author

Listed:
  • Randall P. Ellis

Abstract

Risk adjustment is used in settings with uncertainty to make payments or allow comparisons of outcomes while controlling for exogenous risk factors that explain variations in the outcome of interest, such as spending, utilisation, quality or death. This article focuses on the conceptual and empirical uses of risk adjustment in health economics, where patient-level risk factors are commonly used to explain spending and other outcomes.

Suggested Citation

  • Randall P. Ellis, 2012. "risk adjustment," The New Palgrave Dictionary of Economics, Palgrave Macmillan.
  • Handle: RePEc:pal:dofeco:v:6:year:2012:doi:3872
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    File URL: http://www.dictionaryofeconomics.com/article?id=pde2012_R000283
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    Citations

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    Cited by:

    1. Normann Lorenz, 2014. "Using quantile regression for optimal risk adjustment," Research Papers in Economics 2014-11, University of Trier, Department of Economics.
    2. Geruso, Michael & McGuire, Thomas G., 2016. "Tradeoffs in the design of health plan payment systems: Fit, power and balance," Journal of Health Economics, Elsevier, vol. 47(C), pages 1-19.
    3. Sloan, Frank A. & Picone, Gabriel A. & TaylorJr., Donald H. & Chou, Shin-Yi, 2001. "Hospital ownership and cost and quality of care: is there a dime's worth of difference?," Journal of Health Economics, Elsevier, vol. 20(1), pages 1-21, January.
    4. Jacob Glazer & Thomas G. McGuire & Julie Shi, 2016. "Risk Adjustment of Health Plan Payments to Correct Inefficient Plan Choice from Adverse Selection," NBER Chapters,in: Measuring and Modeling Health Care Costs, pages 379-418 National Bureau of Economic Research, Inc.
    5. Normann Lorenz, 2014. "The interaction of direct and indirect risk selection," Research Papers in Economics 2014-12, University of Trier, Department of Economics.
    6. Sherry Glied, 1999. "Managed Care," NBER Working Papers 7205, National Bureau of Economic Research, Inc.
    7. Jay Bhattacharya & Alan M. Garber & Thomas MaCurdy, 2010. "The Narrowing Dispersion of Medicare Expenditures 1997 to 2005," NBER Chapters,in: Research Findings in the Economics of Aging, pages 387-407 National Bureau of Economic Research, Inc.
    8. Leemore Dafny & David Dranove, 2008. "Do report cards tell consumers anything they don't already know? The case of Medicare HMOs," RAND Journal of Economics, RAND Corporation, vol. 39(3), pages 790-821.
    9. Ernst R. Berndt & David M. Cutler & Richard Frank & Zvi Griliches & Joseph P. Newhouse & Jack E. Triplett, 2001. "Price Indexes for Medical Care Goods and Services -- An Overview of Measurement Issues," NBER Chapters,in: Medical Care Output and Productivity, pages 141-200 National Bureau of Economic Research, Inc.
    10. Brigham Frandsen & James B. Rebitzer, 2014. "Structuring Incentives Within Organizations: The Case of Accountable Care Organizations," NBER Working Papers 20034, National Bureau of Economic Research, Inc.
    11. Frank A. Sloan & Gabriel A. Picone & Donald H. Taylor, Jr. & Shin-Yi Chou, 1999. "Does Where You Are Admitted Make a Difference? An Analysis of Medicare Data," NBER Chapters,in: Frontiers in Health Policy Research, volume 2, pages 1-26 National Bureau of Economic Research, Inc.
    12. Frank, Richard G. & Glazer, Jacob & McGuire, Thomas G., 2000. "Measuring adverse selection in managed health care," Journal of Health Economics, Elsevier, vol. 19(6), pages 829-854, November.
    13. VerĂ³nica Vargas & Juergen Wasem, 2005. "Risk Adjustment and Primary Health Care in Chile," ILADES-Georgetown University Working Papers inv162, Ilades-Georgetown University, Universidad Alberto Hurtado/School of Economics and Bussines.
    14. Alan M. Garber & Thomas E. MaCurdy & Mark B. McClellan, 1997. "Persistence of Medicare Expenditures Among Elderly Beneficiaries," NBER Working Papers 6249, National Bureau of Economic Research, Inc.

    More about this item

    Keywords

    adverse selection; biased selection; health economics; health insurance; health outcomes; life insurance; life tables;

    JEL classification:

    • G22 - Financial Economics - - Financial Institutions and Services - - - Insurance; Insurance Companies; Actuarial Studies
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • G32 - Financial Economics - - Corporate Finance and Governance - - - Financing Policy; Financial Risk and Risk Management; Capital and Ownership Structure; Value of Firms; Goodwill

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