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...
| Publicado en: | Inquiry (00469580) Vol. 50; no. 4; pp. 255 - 275 |
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| Autores principales: | , , , |
| Formato: | equations & formulas research tables/charts Journal Article |
| Publicado: |
Sage Publications Inc.
Nov2013
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=103974481&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 103974481 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00469580 INQ jtl: Inquiry (00469580) issn: 00469580 maglogo: Y pubinfo: dt: Nov2013 vid: 50 iid: 4 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 103974481 97014770 10.1177/0046958014538913 103974481 ppf: 255 ppct: 20 formats: fmt: @attributes: type: P tig: 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 refInfo: holdings: @attributes: islocal: N |
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