| 来源类型 | Working Paper |
| 规范类型 | 报告 |
| DOI | 10.3386/w16977 |
| 来源ID | Working Paper 16977 |
| How does Risk Selection Respond to Risk Adjustment? Evidence from the Medicare Advantage Program | |
| Jason Brown; Mark Duggan; Ilyana Kuziemko; William Woolston | |
| 发表日期 | 2011-04-21 |
| 出版年 | 2011 |
| 语种 | 英语 |
| 摘要 | Governments often contract with private firms to provide public services such as health care and education. To decrease firms' incentives to selectively enroll low-cost individuals, governments frequently "risk-adjust" payments to firms based on enrollees' characteristics. We model how risk adjustment affects selection and differential payments---the government's payments to a firm for covering an individual minus the counterfactual cost had the government directly covered her. We show that firms reduce selection along dimensions included in the risk-adjustment formula, while increasing selection along excluded dimensions. These responses can actually increase differential payments relative to pre-risk-adjustment levels and thus risk adjustment can raise the total cost to the government of providing the public service. We confirm both selection predictions using individual-level data from Medicare, which in 2004 began risk-adjusting payments to private Medicare Advantage plans. We find that differential payments actually rise after risk adjustment and estimate that they totaled $30 billion in 2006, or nearly eight percent of total Medicare spending. |
| 主题 | Public Economics ; National Fiscal Issues ; Health, Education, and Welfare ; Health |
| URL | https://www.nber.org/papers/w16977 |
| 来源智库 | National Bureau of Economic Research (United States) |
| 引用统计 | |
| 资源类型 | 智库出版物 |
| 条目标识符 | http://119.78.100.153/handle/2XGU8XDN/574651 |
| 推荐引用方式 GB/T 7714 | Jason Brown,Mark Duggan,Ilyana Kuziemko,et al. How does Risk Selection Respond to Risk Adjustment? Evidence from the Medicare Advantage Program. 2011. |
| 条目包含的文件 | ||||||
| 文件名称/大小 | 资源类型 | 版本类型 | 开放类型 | 使用许可 | ||
| w16977.pdf（687KB） | 智库出版物 | 限制开放 | CC BY-NC-SA | 浏览 | ||
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