Utilization Thresholds in Risk Adjustment Systems.

Risk adjustment systems, which reallocate funds among competing health insurers, often use risk adjustors that are based on utilization. The level of utilization that triggers an adjustor—the utilization threshold—is frequently chosen implicitly and uniformly. I study utilization thresholds empirica...

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Publicado en:American Journal of Health Economics Vol. 10; no. 3; pp. 470 - 504
Autor principal: Politzer, Eran
Formato: equations & formulas tables/charts Journal Article
Publicado: University of Chicago Press Summer2024
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Summer2024
      vid: 10
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      pub: University of Chicago Press
      place: Chicago, Illinois
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      formats:
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        atl: Utilization Thresholds in Risk Adjustment Systems.
      aug:
        au: Politzer, Eran
      sug:
        subj:
          Insurance, Health Utilization
          Medicaid Utilization
          Health Resource Utilization
          Risk Assessment Methods
          Simulations
          Regression
          Algorithms
          Motivation
          Database Management Software
          Financial Management
          Drugs, Prescription Analysis
          Descriptive Statistics
      ab: Risk adjustment systems, which reallocate funds among competing health insurers, often use risk adjustors that are based on utilization. The level of utilization that triggers an adjustor—the utilization threshold—is frequently chosen implicitly and uniformly. I study utilization thresholds empirically in the setting of the US Marketplaces. I demonstrate how an explicit choice of such thresholds, tailored to each adjustor, may improve the prediction fit of the risk adjustment system and decrease the incentives to game it. Using simulations, I find that a single alternative threshold may improve the prediction fit in some disease groups by up to 14 percent. A choice of multiple utilization thresholds, guided by a regression tree algorithm, may further improve fit while taking into account the effect on gaming incentives.
      pubtype: Academic Journal
      doctype:
        equations & formulas
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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