Optimal cost reimbursement of health insurers to reduce risk selection
Copyright policy )Optimal cost reimbursement of health insurers to reduce risk selection
In the absence of a perfect risk adjustment scheme, reimbursing health insurers' costs can reduce risk selection in community-rated health insurance markets. In this paper, we develop a model in which insurers determine the cost efficiency of health care and have incentives for risk selection. We derive the optimal cost reimbursement function, which balances the incentives for cost efficiency and risk selection. For health cost data from a Swiss health insurer, we find that an optimal cost reimbursement scheme should reimburse costs only up to a threshold.
- University of Trier Germany
- Universität Augsburg Germany
- University of Konstanz Germany
info:eu-repo/classification/gnd/Krankenversicherung, Krankenversicherung, Gesetzliche Krankenversicherung, Insurance Carriers, Efficiency, Organizational, risk adjustment, Sex Factors, Schweiz, info:eu-repo/classification/jel/H42, Humans, risk selection, Adverse Selection, Reimbursement, Incentive, info:eu-repo/classification/ddc/330, Insurance, Health, I18, ddc:330, Age Factors, health insurance,risk selection,risk adjustment, Hospital Charges, Rückvergütung, Models, Economic, Gesundheitskosten, health insurance, info:eu-repo/classification/jel/I18, H42, Risk Adjustment, Health Expenditures, jel: jel:H42, jel: jel:I18
info:eu-repo/classification/gnd/Krankenversicherung, Krankenversicherung, Gesetzliche Krankenversicherung, Insurance Carriers, Efficiency, Organizational, risk adjustment, Sex Factors, Schweiz, info:eu-repo/classification/jel/H42, Humans, risk selection, Adverse Selection, Reimbursement, Incentive, info:eu-repo/classification/ddc/330, Insurance, Health, I18, ddc:330, Age Factors, health insurance,risk selection,risk adjustment, Hospital Charges, Rückvergütung, Models, Economic, Gesundheitskosten, health insurance, info:eu-repo/classification/jel/I18, H42, Risk Adjustment, Health Expenditures, jel: jel:H42, jel: jel:I18
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