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On the calculation of the Israeli risk adjustment rates

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  • Amir Shmueli

Abstract

The current risk adjustment formula distorts the intended competition on good quality care among the sickness funds, and turns it into a competition on profitable members. After 18 years of using incorrect rates, the Israeli risk adjustment rates should be calculated, as is common in other systems, based on individual cost data from the sickness funds. Copyright Springer-Verlag Berlin Heidelberg 2015

Suggested Citation

  • Amir Shmueli, 2015. "On the calculation of the Israeli risk adjustment rates," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(3), pages 271-277, April.
    • Handle: RePEc:spr:eujhec:v:16:y:2015:i:3:p:271-277
    DOI: 10.1007/s10198-014-0572-x
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    References listed on IDEAS

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    1. Chernichovsky, Dov & Zmora, Irit, 1986. "A hedonic prices approach to hospitalization costs : The case of Israel," Journal of Health Economics, Elsevier, vol. 5(2), pages 179-191, June.
    2. 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.
    3. Thomas G. McGuire & Jacob Glazer, 2000. "Optimal Risk Adjustment in Markets with Adverse Selection: An Application to Managed Care," American Economic Review, American Economic Association, vol. 90(4), pages 1055-1071, September.
    4. Shmueli, Amir & Chernichovsky, Dov & Zmora, Irit, 2003. "Risk adjustment and risk sharing: the Israeli experience," Health Policy, Elsevier, vol. 65(1), pages 37-48, July.
    5. Nigel Rice & Peter Smith, 1999. "Approaches to capitation and risk adjustment in health care: an international survey," Working Papers 038cheop, Centre for Health Economics, University of York.
    6. Shmueli, Amir & Nissan-Engelcin, Esti, 2013. "Local availability of physicians' services as a tool for implicit risk selection," Social Science & Medicine, Elsevier, vol. 84(C), pages 53-60.
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    Citations

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    Cited by:

    1. Pilny, Adam & Wübker, Ansgar & Ziebarth, Nicolas R., 2017. "Introducing risk adjustment and free health plan choice in employer-based health insurance: Evidence from Germany," Journal of Health Economics, Elsevier, vol. 56(C), pages 330-351.
    2. Frank Eijkenaar & René C. J. A. Vliet, 2018. "Improving risk equalization using information on physiotherapy diagnoses," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(2), pages 203-211, March.
    3. Eijkenaar, Frank & van Vliet, René C.J.A., 2017. "Improving risk equalization for individuals with persistently high costs: Experiences from the Netherlands," Health Policy, Elsevier, vol. 121(11), pages 1169-1176.
    4. Wynand P. M. M. Ven & René C. J. A. Vliet & Richard C. Kleef, 2017. "How can the regulator show evidence of (no) risk selection in health insurance markets? Conceptual framework and empirical evidence," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(2), pages 167-180, March.

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    More about this item

    Keywords

    Risk adjustment; National health insurance; Risk selection; Israel; I11; I13; I18;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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