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....

Objectives: To contribute to the policy discussion of equity and health financing in Chile by evaluating the improvement in the capitation formula for paying PHC providers by using selected diagnoses. The socio-economic status of the municipalities and the urban/rural location of providers are...

Although global investors have been paying more heed than ever to Corporate Governance for the last decade, the evolving premium risk stemming from variegated governance issues has not been factored yet into the expected return of any investor's portfolio. From a theoretical standpoint, this...

When public long-term care (LTC) insurance is provided by insurers, they typically lack incentives for purchasing cost-effective LTC. Providing insurers with appropriate incentives for efficiency without jeopardizing access for high-risk individuals requires, among other things, an adequate...

This paper analyzes the distortions of health insurers' benefit packages due to adverse selection when there is imperfect competition. Within a discrete choice setting with two risk types, the following main results are derived: For intermediate levels of competition, the benefit packages of...

To equalize differences in health plan premiums due to differences in risk pools, the German legislature introduced a simple Risk Adjustment Scheme (RAS) based on age, gender and disability status in 1994. In addition, effective 1996, consumers gained the freedom to choose among hundreds of...

To equalize differences in health plan premiums due to differences in risk pools, the German legislature introduced a simple Risk Adjustment Scheme (RAS) based on age, gender and disability status in 1994. In addition, effective 1996, consumers gained the freedom to choose among hundreds of...

The Affordable Care Act (ACA) allows state variation in implementing health reform. Critical to a stable health insurance market under reform is the use of risk adjustment to share risks across insurance plans. The ACA requires states to implement risk adjustment, but a California-specific risk...

Summary In Germany, there is an ongoing debate on how to finance the statutory health insurance (SHI). Proposals include a “civic insurance” with a contribution rate drawn on a broader base and capitated payments. This debate will not subside with the recently issued white paper on health...