کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
7362641 | 1478951 | 2018 | 18 صفحه PDF | دانلود رایگان |
عنوان انگلیسی مقاله ISI
Deriving risk adjustment payment weights to maximize efficiency of health insurance markets
ترجمه فارسی عنوان
به دست آوردن مقادیر پرداخت خطر سازگاری برای به حداکثر رساندن بازده بازار بیمه درمانی
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کلمات کلیدی
بیمه سلامت، تنظیم ریسک، انتخاب نامطلوب،
موضوعات مرتبط
علوم پزشکی و سلامت
پزشکی و دندانپزشکی
سیاست های بهداشت و سلامت عمومی
چکیده انگلیسی
Risk-adjustment is critical to the functioning of regulated health insurance markets. To date, estimation and evaluation of a risk-adjustment model has been based on statistical rather than economic objective functions. We develop a framework where the objective of risk-adjustment is to minimize the efficiency loss from service-level distortions due to adverse selection, and we use the framework to develop a welfare-grounded method for estimating risk-adjustment weights. We show that when the number of risk adjustor variables exceeds the number of decisions plans make about service allocations, incentives for service-level distortion can always be eliminated via a constrained least-squares regression. When the number of plan service-level allocation decisions exceeds the number of risk-adjusters, the optimal weights can be found by an OLS regression on a straightforward transformation of the data. We illustrate this method with the data used to estimate risk-adjustment payment weights in the Netherlands (Nâ=â16.5 million).
ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of Health Economics - Volume 61, September 2018, Pages 93-110
Journal: Journal of Health Economics - Volume 61, September 2018, Pages 93-110
نویسندگان
Timothy J. Layton, Thomas G. McGuire, Richard C. van Kleef,