"Risk adjustment, risk sharing and premium regulation in health insurance markets: theory and practice" describes the goals, design and evaluation of health plan payment systems. Part I contains 5 chapters discussing the role of health plan payment in regulated health insurance markets, key...

Front Cover -- Risk Adjustment, Risk Sharing and Premium Regulation in Health Insurance Markets -- Copyright Page -- Contents -- List of Contributors -- Regulated Competition in Health Insurance Markets: Foreword by Alain Enthoven -- Acknowledgments -- I: Theory -- 1 Regulated Competition in...

Health plan payment systems with community-rated premiums typically include risk adjustment, risk sharing or both to compensate insurers for predictable profits (on young and healthy people) and predictable losses (on the elderly and chronically ill). This paper shows how a payment system based...