Risk Adjustment: The Missing Piece of Market Competition

Autor:	John Ramey, Sandra Hunt, John Bertko, Sandra Shewry
Rok vydání:	1996
Předmět:	Risk Management Market competition Actuarial science Cost Control Process (engineering) State Health Plans Health Policy Managed Competition Risk adjustment California United States Health Benefit Plans Employee Economics Humans Health risk Health insurance plan
Zdroj:	Health Affairs. 15:171-181
ISSN:	1544-5208 0278-2715
DOI:	10.1377/hlthaff.15.1.171
Popis:	This DataWatch describes the process adopted by The Health Insurance Plan of California (The HIPC) for assessing and adjusting for health risk differences among participating health plans. We also report on the results of the 1996 risk assessment/adjustment calculations. A risk assessment value is calculated for each health plan based on the plan's enrollee mix as compared with the mix of enrollees in The HIPC as a whole. The results indicated that approximately 1 percent of total premium dollars needs to be transferred to bring all health plan scores within the acceptable level (+/- 5 percent) of risk distribution.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::22859e083168b93a0c23a6bc068d1586 https://doi.org/10.1377/hlthaff.15.1.171 Zobrazit plný text záznamu