Global Risk-Adjusted Payment Models
Author
Abstract
Suggested Citation
Download full text from publisher
References listed on IDEAS
- 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.
- Francesco Decarolis, 2015. "Medicare Part D: Are Insurers Gaming the Low Income Subsidy Design?," American Economic Review, American Economic Association, vol. 105(4), pages 1547-1580, April.
- 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.
- Orueta, Juan-Francisco & Urraca, Javier & Berraondo, Inaki & Darpon, Jon & Aurrekoetxea, Juan-Jose, 2006. "Adjusted Clinical Groups (ACGs) explain the utilization of primary care in Spain based on information registered in the medical records: A cross-sectional study," Health Policy, Elsevier, vol. 76(1), pages 38-48, March.
- Beck, Konstantin & Spycher, Stefan & Holly, Alberto & Gardiol, Lucien, 2003. "Risk adjustment in Switzerland," Health Policy, Elsevier, vol. 65(1), pages 63-74, July.
- Lamers, Leida M. & van Vliet, Rene C. J. A. & van de Ven, Wynand P. M. M., 2003. "Risk adjusted premium subsidies and risk sharing: key elements of the competitive sickness fund market in the Netherlands," Health Policy, Elsevier, vol. 65(1), pages 49-62, July.
- Jacob Glazer & Thomas G. McGuire & Julie Shi, 2016.
"Risk Adjustment of Health Plan Payments to Correct Inefficient Plan Choice from Adverse Selection,"
NBER Chapters, in: Measuring and Modeling Health Care Costs, pages 379-418,
National Bureau of Economic Research, Inc.
- Jacob Glazer & Thomas McGuire & Julie Shi, 2014. "Risk Adjustment of Health Plan Payments to Correct Inefficient Plan Choice from Adverse Selection," NBER Working Papers 19998, National Bureau of Economic Research, Inc.
- Breyer, Friedrich & Bundorf, M. Kate & Pauly, Mark V., 2011. "Health Care Spending Risk, Health Insurance, and Payment to Health Plans," Handbook of Health Economics, in: Mark V. Pauly & Thomas G. Mcguire & Pedro P. Barros (ed.), Handbook of Health Economics, volume 2, chapter 0, pages 691-762, Elsevier.
- van de Ven, Wynand P.M.M. & Beck, Konstantin & Buchner, Florian & Schokkaert, Erik & Schut, F.T. (Erik) & Shmueli, Amir & Wasem, Juergen, 2013. "Preconditions for efficiency and affordability in competitive healthcare markets: Are they fulfilled in Belgium, Germany, Israel, the Netherlands and Switzerland?," Health Policy, Elsevier, vol. 109(3), pages 226-245.
- Wagstaff, Adam, 2009. "Social health insurance vs. tax-financed health systems - evidence from the OECD," Policy Research Working Paper Series 4821, The World Bank.
- Randall P. Ellis & Denzil G. Fiebig & Meliyanni Johar & Glenn Jones & Elizabeth Savage, 2013.
"Explaining Health Care Expenditure Variation: Large‐Sample Evidence Using Linked Survey And Health Administrative Data,"
Health Economics, John Wiley & Sons, Ltd., vol. 22(9), pages 1093-1110, September.
- Randall P. Ellis & Denzil G. Fiebig & Meliyanni Johar & Glenn Jones & Elizabeth Savage, 2012. "Explaining Health Care Expenditure Variation: Large-sample Evidence Using Linked Survey and Health Administrative Data," Working Paper Series 1, Economics Discipline Group, UTS Business School, University of Technology, Sydney.
- van Barneveld, Erik M. & Lamers, Leida M. & van Vliet, Rene C. J. A. & van de Ven, Wynand P. M. M., 2001. "Risk sharing as a supplement to imperfect capitation: a tradeoff between selection and efficiency," Journal of Health Economics, Elsevier, vol. 20(2), pages 147-168, March.
- 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.
- Buchner, Florian & Wasem, Jurgen, 2003. "Needs for further improvement: risk adjustment in the German health insurance system," Health Policy, Elsevier, vol. 65(1), pages 21-35, July.
- van de Ven, Wynand P. M. M. & Beck, Konstantin & Buchner, Florian & Chernichovsky, Dov & Gardiol, Lucien & Holly, Alberto & Lamers, Leida M. & Schokkaert, Erik & Shmueli, Amir & Spycher, Stephan & Van, 2003. "Risk adjustment and risk selection on the sickness fund insurance market in five European countries," Health Policy, Elsevier, vol. 65(1), pages 75-98, July.
- 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.
- Göpffarth, Dirk & Henke, Klaus-Dirk, 2013. "The German Central Health Fund—Recent developments in health care financing in Germany," Health Policy, Elsevier, vol. 109(3), pages 246-252.
- Valérie Paris & Marion Devaux & Lihan Wei, 2010. "Health Systems Institutional Characteristics: A Survey of 29 OECD Countries," OECD Health Working Papers 50, OECD Publishing.
- Van de ven, Wynand P.M.M. & Ellis, Randall P., 2000. "Risk adjustment in competitive health plan markets," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 14, pages 755-845, Elsevier.
- Randall P. Ellis & Juan Gabriel Fernandez, 2013.
"Risk Selection, Risk Adjustment and Choice: Concepts and Lessons from the Americas,"
IJERPH, MDPI, vol. 10(11), pages 1-34, October.
- Randall P. Ellis & Juan Gabriel Fernandez, 2013. "Risk Selection, Risk Adjustment and Choice: Concepts and Lessons from the Americas," Boston University - Department of Economics - Working Papers Series wp2013-025, Boston University - Department of Economics, revised 30 Sep 2013.
- Sonal Vats & Arlene S. Ash & Randall P. Ellis, 2013. "Bending the Cost Curve? Results from a Comprehensive Primary Care Payment Pilot," Boston University - Department of Economics - Working Papers Series wp2013-024, Boston University - Department of Economics.
- Schokkaert, Erik & Van de Voorde, Carine, 2003. "Belgium: risk adjustment and financial responsibility in a centralised system," Health Policy, Elsevier, vol. 65(1), pages 5-19, July.
- Verónica Vargas & Juergen Wasem, 2005. "Risk Adjustment and Primary Health Care in Chile," ILADES-UAH Working Papers inv162, Universidad Alberto Hurtado/School of Economics and Business.
- World Bank, 2011. "World Bank for Results 2011," World Bank Publications - Books, The World Bank Group, number 15792.
- Joseph P. Newhouse, 1996. "Reimbursing Health Plans and Health Providers: Efficiency in Production versus Selection," Journal of Economic Literature, American Economic Association, vol. 34(3), pages 1236-1263, September.
Most related items
These are the items that most often cite the same works as this one and are cited by the same works as this one.- Manuel García-Goñi & Pere Ibern & José Inoriza, 2009.
"Hybrid risk adjustment for pharmaceutical benefits,"
The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 10(3), pages 299-308, July.
- Manuel García-Goñi & Pere Ibern & José María Inoriza, 2009. "Hybrid risk adjustment for pharmaceutical benefits," Economics Working Papers 1139, Department of Economics and Business, Universitat Pompeu Fabra.
- 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.
- Deber, Raisa B. & Forget, Evelyn L. & Roos, Leslie L., 2004. "Medical savings accounts in a universal system: wishful thinking meets evidence," Health Policy, Elsevier, vol. 70(1), pages 49-66, October.
- 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.
- Adam Pilny & Ansgar Wübker & Nicolas R. Ziebarth, 2017. "Introducing Risk Adjustment and Free Health Plan Choice in Employer-Based Health Insurance: Evidence from Germany," SOEPpapers on Multidisciplinary Panel Data Research 915, DIW Berlin, The German Socio-Economic Panel (SOEP).
- Pilny, Adam & Wübker, Ansgar & Ziebarth, Nicolas R., 2017. "Introducing Risk Adjustment and Free Health Plan Choice in Employer-Based Health Insurance: Evidence from Germany," IZA Discussion Papers 10870, Institute of Labor Economics (IZA).
- Pilny, Adam & Wübker, Ansgar & Ziebarth, Nicolas R., 2017. "Introducing risk adjustment and free health plan choice in employer-based health insurance: Evidence from Germany," Ruhr Economic Papers 682, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
- Pilny, Adam & Wübker, Ansgar & Ziebarth, Nicolas R., 2017. "Introducing Risk Adjustment and Free Health Plan Choice in Employer-Based Health Insurance: Evidence from Germany," VfS Annual Conference 2017 (Vienna): Alternative Structures for Money and Banking 168121, Verein für Socialpolitik / German Economic Association.
- Xu, Weiwei & van de Ven, Wynand P.M.M., 2013. "Consumer choice among Mutual Healthcare Purchasers: A feasible option for China?," Social Science & Medicine, Elsevier, vol. 96(C), pages 277-284.
- Shuli Brammli-Greenberg & Jacob Glazer & Ruth Waitzberg, 2019. "Modest risk-sharing significantly reduces health plans’ incentives for service distortion," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(9), pages 1359-1374, December.
- A. A. Withagen-Koster & R. C. Kleef & F. Eijkenaar, 2018. "Examining unpriced risk heterogeneity in the Dutch health insurance market," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(9), pages 1351-1363, December.
- Ayman Fouda & Gianluca Fiorentini & Francesco Paolucci, 2017. "Competitive Health Markets and Risk Equalisation in Australia: Lessons Learnt from Other Countries," Applied Health Economics and Health Policy, Springer, vol. 15(6), pages 745-754, December.
- repec:sgm:pzwzuw:v:1:i:2:y:2013:p:193-203 is not listed on IDEAS
- Schokkaert, Erik & Van de Voorde, Carine, 2009.
"Direct versus indirect standardization in risk adjustment,"
Journal of Health Economics, Elsevier, vol. 28(2), pages 361-374, March.
- Erik Schokkaert & Carine Van De Voorde, 2007. "Direct versus indirect standaardization in risk adjustment," Working Papers of Department of Economics, Leuven ces0733, KU Leuven, Faculty of Economics and Business (FEB), Department of Economics, Leuven.
- SCHOKKAERT, Erik & VAN DE VOORDE, Carine, 2009. "Direct versus indirect standardization in risk adjustment," LIDAM Reprints CORE 2139, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
- Manuel García-Goñi & Pere Ibern & José María Inoriza, 2009. "Hybrid risk adjustment for pharmaceutical benefits," Working Papers, Research Center on Health and Economics 1139, Department of Economics and Business, Universitat Pompeu Fabra.
- Barbara Wieckowska, 2013. "Systemy wyrownywania szkodowosci funkcjonujace w bazowych systemach zabezpieczenia zdrowotnego z konkurencja pomiedzy platnikami trzeciej strony. (Claims equalization systems, operating in the health ," Problemy Zarzadzania, University of Warsaw, Faculty of Management, vol. 11(41), pages 193-203.
- Schmid, Christian P.R. & Beck, Konstantin, 2016. "Re-insurance in the Swiss health insurance market: Fit, power, and balance," Health Policy, Elsevier, vol. 120(7), pages 848-855.
- Michele Fioretti & Hongming Wang, 2023.
"Performance Pay in Insurance Markets: Evidence from Medicare,"
The Review of Economics and Statistics, MIT Press, vol. 105(5), pages 1128-1144, September.
- Michele Fioretti & Hongming Wang, 2020. "Performance Pay in Insurance Markets: Evidence from Medicare," Working Papers 2020.03, International Network for Economic Research - INFER.
- Michele Fioretti & Hongming Wang, 2021. "Performance Pay in Insurance Markets: Evidence from Medicare," Post-Print hal-03791843, HAL.
- Michele Fioretti & Hongming Wang, 2021. "Performance Pay in Insurance Markets: Evidence from Medicare," SciencePo Working papers Main hal-03386584, HAL.
- Michele Fioretti & Hongming Wang, 2021. "Performance Pay in Insurance Markets: Evidence from Medicare," SciencePo Working papers Main hal-03791843, HAL.
- Michele Fioretti & Hongming Wang, 2021. "Performance Pay in Insurance Markets: Evidence from Medicare," SciencePo Working papers hal-03386584, HAL.
- Michele Fioretti & Hongming Wang, 2021. "Performance Pay in Insurance Markets: Evidence from Medicare," Working Papers hal-03386584, HAL.
- Mathias Kifmann & Normann Lorenz, 2011.
"Optimal cost reimbursement of health insurers to reduce risk selection,"
Health Economics, John Wiley & Sons, Ltd., vol. 20(5), pages 532-552, May.
- Kifmann, Mathias & Lorenz, Normann, 2005. "Optimal cost reimbursement of health insurers to reduce risk selection," Discussion Papers, Series I 329, University of Konstanz, Department of Economics.
- Danny Wende, 2019. "Spatial risk adjustment between health insurances: using GWR in risk adjustment models to conserve incentives for service optimisation and reduce MAUP," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(7), pages 1079-1091, September.
- Jacob Glazer & Thomas G. McGuire, 2006. "Contending with Risk Selection in Health Insurance Markets in Germany," Perspektiven der Wirtschaftspolitik, Verein für Socialpolitik, vol. 7(s1), pages 75-91, May.
- Michiel Bijlsma & Jan Boone & Gijsbert Zwart, 2014.
"Competition leverage: how the demand side affects optimal risk adjustment,"
RAND Journal of Economics, RAND Corporation, vol. 45(4), pages 792-815, December.
- Bijlsma, M. & Boone, J. & Zwart, Gijsbert, 2011. "Competition Leverage : How the Demand Side Affects Optimal Risk Adjustment," Other publications TiSEM c7739c3e-866e-4509-bfc2-e, Tilburg University, School of Economics and Management.
- Bijlsma, M. & Boone, J. & Zwart, Gijsbert, 2011. "Competition Leverage : How the Demand Side Affects Optimal Risk Adjustment," Discussion Paper 2011-071, Tilburg University, Center for Economic Research.
- Boone, Jan & Zwart, Gijsbert, 2011. "Competition leverage: how the demand side affects optimal risk adjustment," CEPR Discussion Papers 8461, C.E.P.R. Discussion Papers.
- Michiel Bijlsma & Gijsbert Zwart & Jan Boone, 2011. "Competition leverage: How the demand side affects optimal risk adjustment," CPB Discussion Paper 181, CPB Netherlands Bureau for Economic Policy Analysis.
- 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.
- 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.
- Mark Stabile & Sarah Thomson, 2014.
"The Changing Role of Government in Financing Health Care: An International Perspective,"
Journal of Economic Literature, American Economic Association, vol. 52(2), pages 480-518, June.
- Mark Stabile & Sarah Thomson, 2013. "The Changing Role of Government in Financing Health Care: An International Perspective," NBER Working Papers 19439, National Bureau of Economic Research, Inc.
- Stabile, Mark & Thomson, Sarah, 2014. "The changing role of government in financing health care: an international perspective," LSE Research Online Documents on Economics 59223, London School of Economics and Political Science, LSE Library.
- Mark Stabile & Sarah Thomson, 2014. "The Changing Role of Government in Financing Health Care: An International Perspective," Working Papers hal-03460310, HAL.
Corrections
All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:bos:wpaper:wp2015-021. See general information about how to correct material in RePEc.
If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.
If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .
If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Program Coordinator (email available below). General contact details of provider: https://edirc.repec.org/data/decbuus.html .
Please note that corrections may take a couple of weeks to filter through the various RePEc services.