Risk adjustment of the allocated health budget to health plans plays a major role in the functioning of competitive social health insurance systems. Whenever the risk adjusted allocation is below the expected marginal cost of care for a given person, incentives for risk selection arise. Since...

This paper uses medical care costs of joiners in their first year and of leavers in their last year prior the move, relative to the age–sex groups’ means, to examine the mechanisms behind the switching decisions. Since under the Israeli National Health Insurance Scheme no premiums are paid...

The current risk adjustment formula distorts the intended competition on good quality care among the sickness funds, and turns it into a competition on profitable members. After 18 years of using incorrect rates, the Israeli risk adjustment rates should be calculated, as is common in other...