Research Paper. The Power of Reinsurance in Health Insurance Exchanges to Improve the Fit of the Payment System and Reduce Incentives for Adverse Selection.

Risk adjustment and reinsurance protect plans against risk of losses and contend with adverse selection in the new health insurance Exchanges. This article assesses the power of reinsurance in the context of other plan payment features, including prospective and concurrent risk adjustment. Using dat...

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Publicado en:Inquiry (00469580) Vol. 50; no. 4; pp. 255 - 275
Autores principales: Zhu, Jane M., Layton, Timothy, Sinaiko, Anna D., McGuire, Thomas G.
Formato: equations & formulas research tables/charts Journal Article
Publicado: Sage Publications Inc. Nov2013
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Research Paper. The Power of Reinsurance in Health Insurance Exchanges to Improve the Fit of the Payment System and Reduce Incentives for Adverse Selection.
      aug:
        au:
          Zhu, Jane M.
          Layton, Timothy
          Sinaiko, Anna D.
          McGuire, Thomas G.
        affil: University of California San Francisco, San Francisco, CA, USA; Harvard Medical School, Boston, MA, USA
      sug:
        subj:
          Health Insurance Exchanges
          Insurance Classification
          Selection Bias
          Risk Management Methods
          Risk Management Economics
          Human
          Funding Source
          Medicare Statistics and Numerical Data
          United States
          Administrative Research
          Computer Simulation
          Quality Improvement
          Disease Management
          Retrospective Design
          Health Care Costs
          Fees and Charges
          Insurance Carriers
          Descriptive Statistics
          Prospective Payment System
          Predictive Validity
          Analytic Research
      ab: Risk adjustment and reinsurance protect plans against risk of losses and contend with adverse selection in the new health insurance Exchanges. This article assesses the power of reinsurance in the context of other plan payment features, including prospective and concurrent risk adjustment. Using data from the Medicare Expenditure Panel Survey (MEPS) to draw an “Exchange population,” we simulate the contribution of reinsurance to improving the fit of the payment system to plan costs and to mitigating incentives for adverse selection for groups of enrollees with selected chronic illnesses. Modest reductions in attachment points equate the payment-system fit of retrospective to concurrent risk adjustment. Reinsurance is very powerful in fitting payments to costs and moderately effective in dealing with selection incentives.
      pubtype: Academic Journal
      doctype:
        equations & formulas
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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