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The new risk adjustment formula in Germany: Implementation and first experiences

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  • Buchner, Florian
  • Goepffarth, Dirk
  • Wasem, Juergen

Abstract

In Germany risk adjustment is a core element of the regulatory framework of competition between sickness funds. It shall create a level playing field between funds with very heterogeneous risk structures. Prior to 2009 risk adjustment was mainly by a demographic model. In 2009 morbidity based risk adjustment was introduced, embedded in a broader reform of the statutory health insurance system. The new formula covers 80 “severe” or “costly and chronic” diseases structured in a system of hierarchical groups.

Suggested Citation

  • Buchner, Florian & Goepffarth, Dirk & Wasem, Juergen, 2013. "The new risk adjustment formula in Germany: Implementation and first experiences," Health Policy, Elsevier, vol. 109(3), pages 253-262.
    • Handle: RePEc:eee:hepoli:v:109:y:2013:i:3:p:253-262
    DOI: 10.1016/j.healthpol.2012.12.001
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    References listed on IDEAS

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    1. van de Ven, Wynand P.M.M. & Beck, Konstantin & Van de Voorde, Carine & Wasem, Jurgen & Zmora, Irit, 2007. "Risk adjustment and risk selection in Europe: 6 years later," Health Policy, Elsevier, vol. 83(2-3), pages 162-179, October.
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