G2TT
来源类型Working Paper
规范类型报告
DOI10.3386/w25374
来源IDWorking Paper 25374
Reinsurance, Repayments, and Risk Adjustment in Individual Health Insurance: Germany, The Netherlands and the U.S. Marketplaces
Thomas G. McGuire; Sonja Schillo; Richard C. van Kleef
发表日期2018-12-24
出版年2018
语种英语
摘要Reinsurance can complement risk adjustment of health plan payments to improve fit of payments to plan spending at the individual and group level. This paper proposes three improvements in health plan payment systems using reinsurance. First, we base reinsurance payments on spending not accounted for by the risk adjustment system, rather than just high spending. Second, we propose pairing reinsurance for individual-level losses with repayments for individual-level profits. Third, we optimize the weights on the risk adjustors taking account of the presence of reinsurance/repayment. We implement our methodology in data from Germany, The Netherlands and the U.S. Marketplaces, comparing our modified approach to plan payment with risk adjustment as currently practiced in the three settings. The combination of the three improvements yields very substantial improvements in the individual-level fit of payments to plan spending in all three countries.
主题Health, Education, and Welfare ; Health
URLhttps://www.nber.org/papers/w25374
来源智库National Bureau of Economic Research (United States)
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资源类型智库出版物
条目标识符http://119.78.100.153/handle/2XGU8XDN/583048
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GB/T 7714
Thomas G. McGuire,Sonja Schillo,Richard C. van Kleef. Reinsurance, Repayments, and Risk Adjustment in Individual Health Insurance: Germany, The Netherlands and the U.S. Marketplaces. 2018.
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