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...

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...

Front Cover -- Risk Adjustment, Risk Sharing and Premium Regulation in Health Insurance Markets -- Copyright Page -- Contents -- List of Contributors -- Regulated Competition in Health Insurance Markets: Foreword by Alain Enthoven -- Acknowledgments -- I: Theory -- 1 Regulated Competition in...

"Risk adjustment, risk sharing and premium regulation in health insurance markets: theory and practice" describes the goals, design and evaluation of health plan payment systems. Part I contains 5 chapters discussing the role of health plan payment in regulated health insurance markets, key...