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Risk sharing as a supplement to imperfect capitation: a tradeoff between selection and efficiency.

E M van Barneveld1, L M Lamers, R C van Vliet

  • 1Department of Health Policy and Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands. e.van.barneveld@agis-groep.nl

Journal of Health Economics
|March 17, 2001
PubMed
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This study examines risk sharing between health insurers and regulators, finding that current methods like outlier or proportional risk sharing may not be optimal. Alternative risk-sharing strategies could better balance insurer selection and efficiency incentives.

Area of Science:

  • Health economics
  • Insurance market regulation
  • Risk management

Background:

  • Competitive individual health insurance markets face challenges with imperfect risk adjustment.
  • Capitation payments can incentivize adverse selection and reduce efficiency.
  • Regulators use risk-sharing mechanisms to mitigate these issues.

Purpose of the Study:

  • To analyze the impact of risk sharing on insurer incentives for selection and efficiency.
  • To determine the optimal extent of risk sharing in health insurance markets.
  • To compare different risk-sharing methods.

Main Methods:

  • Theoretical analysis of risk-sharing models.
  • Empirical investigation of various risk-sharing forms.
  • Evaluation of tradeoffs between selection and efficiency.

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Main Results:

  • Risk sharing reduces insurer incentives for both selection and efficiency.
  • The optimal level of risk sharing depends on regulatory priorities.
  • Current outlier or proportional risk sharing may not be the most effective.

Conclusions:

  • Alternative risk-sharing mechanisms can offer improved tradeoffs.
  • Regulators should consider diverse risk-sharing strategies.
  • Optimizing risk sharing is crucial for efficient health insurance markets.