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
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
Year of publication: |
December 2018
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Authors: | McGuire, Thomas G. |
Other Persons: | Schillo, Sonja (contributor) ; van Kleef, Richard C. (contributor) |
Institutions: | National Bureau of Economic Research (contributor) |
Publisher: |
2018: Cambridge, Mass : National Bureau of Economic Research |
Subject: | Niederlande | Netherlands | USA | United States | Deutschland | Germany | Private Krankenversicherung | Private health insurance |
Saved in:
freely available
Extent: | 1 Online-Ressource illustrations (black and white) |
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Series: | NBER working paper series ; no. w25374 |
Type of publication: | Book / Working Paper |
Language: | English |
Notes: | System requirements: Adobe [Acrobat] Reader required for PDF files Mode of access: World Wide Web Hardcopy version available to institutional subscribers |
Other identifiers: | 10.3386/w25374 [DOI] |
Source: | ECONIS - Online Catalogue of the ZBW |
Persistent link: https://www.econbiz.de/10012481022