PMID: 11921314Mar 29, 2002Paper

How profitable is risk selection? A comparison of four risk adjustment models

Health Economics
Yujing Shen, R P Ellis

Abstract

To mitigate selection triggered by capitation payments, risk-adjustment models bring capitation payments closer on average to individuals' expected expenditure. We examine the maximum potential profit that plans could hypothetically gain by using their own private information to select low-cost enrollees when payments are made using four commonly used risk adjustment models. Simulations using a privately insured sample suggest that risk selection profits remain substantial. The magnitude of potential profit varies according to the risk adjustment model and the private information plans can employ to identify profitable enrollees.

References

Apr 1, 1991·Medical Care·R LichtensteinB Simone
Oct 7, 1997·Health Affairs·J P NewhouseJ D Chapman
Jan 28, 1998·Health Affairs·A C Enthoven, S J Singer
Oct 8, 1982·Operations Research·R D Feldman, B E Dowd

❮ Previous
Next ❯

Citations

Sep 29, 2004·The European Journal of Health Economics : HEPAC : Health Economics in Prevention and Care·Kathryn M Antioch, Michael K Walsh
May 23, 2002·Journal of Health Economics·Yujing Shen, Randall P Ellis
Nov 24, 2006·Medical Care·Bonnie K LindDavid E Grembowski
Jan 18, 2003·Australian and New Zealand Journal of Public Health·S J Duckett, P A Agius
Feb 11, 2005·Applied Health Economics and Health Policy·Randall S StaffordLisa I Iezzoni
Nov 29, 2013·International Journal of Environmental Research and Public Health·Randall P Ellis, Juan Gabriel Fernandez
Jan 5, 2002·Inquiry : a Journal of Medical Care Organization, Provision and Financing·J Glazer, T G McGuire
Sep 29, 2004·Inquiry : a Journal of Medical Care Organization, Provision and Financing·Harold S Luft, R Adams Dudley
Feb 4, 2016·The European Journal of Health Economics : HEPAC : Health Economics in Prevention and Care·Wynand P M M van de VenRichard C van Kleef
May 14, 2010·Journal of Health Economics·Patrick EugsterPeter Zweifel
May 4, 2010·Journal of Health Economics·Konstantin BeckPeter Zweifel
Aug 16, 2006·Journal of Health Economics·Randall P Ellis, Thomas G McGuire
Jul 18, 2006·Thrombosis Research·Carl van WalravenAlan J Forster
May 4, 2015·Journal of Health Economics·Normann Lorenz
Dec 3, 2014·Atencion primaria·Pablo de MiguelÁngel Gómez
Feb 11, 2015·The European Journal of Health Economics : HEPAC : Health Economics in Prevention and Care·Viktor von Wyl, Konstantin Beck
Feb 20, 2015·Medical Care Research and Review : MCRR·S H C M van VeenR C J A van Vliet
Jan 25, 2013·Asia-Pacific Journal of Public Health·Hsien-Yen ChangJonathan P Weiner
Jun 1, 2015·International Journal of Health Economics and Management·Pieter BakxEddy van Doorslaer

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

Journal of Health Economics
Yujing Shen, R P Ellis
Journal of Health Economics
R G FrankT G McGuire
Australian Health Review : a Publication of the Australian Hospital Association
R Scotton
Australian Health Review : a Publication of the Australian Hospital Association
K Antioch, X Zhang
© 2022 Meta ULC. All rights reserved