Risk-adjustment systems used to pay health plans in individual health insurance markets have evolved towards better "fit" of payments to plan spending, at the individual and group levels, generally achieved by adding variables used for risk adjustment. Adding variables demands further plan and...

Risk-adjustment systems used to pay health plans in individual health insurance markets have evolved towards better “fit” of payments to plan spending, at the individual and group levels, generally achieved by adding variables used for risk adjustment. Adding variables demands further plan...

Health plan payment systems with community-rated premiums typically include risk adjustment, risk sharing or both to compensate insurers for predictable profits (on young and healthy people) and predictable losses (on the elderly and chronically ill). This paper shows how a payment system based...