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Related Experiment Videos

Potential methods to reduce risk selection and its effects

H S Luft1

  • 1Institute for Health Policy Studies, School of Medicine, University of California, San Francisco 94109, USA.

Inquiry : a Journal of Medical Care Organization, Provision and Financing
|January 1, 1995
PubMed
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To maintain voluntary health plan enrollment, risk differences must be assessed and payments adjusted. Group-level cost approximation and a neutral referee can mitigate selection issues in purchasing cooperatives.

Area of Science:

  • Health economics
  • Health services research
  • Insurance risk adjustment

Background:

  • Voluntary enrollment and health plan choice are desirable features in healthcare systems.
  • These choices can lead to significant risk differences among enrollees.
  • Managing these risk differences is crucial for financial stability and equity.

Purpose of the Study:

  • To explore methods for assessing and adjusting for risk differences in voluntary health plan enrollment.
  • To examine the feasibility of approximating costs for large employee groups in purchasing cooperatives.
  • To identify strategies for mitigating risk selection problems within cooperative settings.

Main Methods:

  • Analysis of risk differences inherent in voluntary health plan selection.

Related Experiment Videos

  • Feasibility assessment of approximating large group costs within purchasing cooperatives.
  • Conceptualization of a referee mechanism for risk adjustment in zero-sum settings.

    • Main Results:

    • Perfect individual cost prediction is impossible, but group-level approximation is feasible.
    • Employee groups and cooperatives present opportunities for risk selection.
    • A neutral referee can potentially reduce selection problems.

    Conclusions:

    • Assessing and adjusting for risk differences is essential for preserving voluntary enrollment.
    • Purchasing cooperatives require robust mechanisms to manage risk selection.
    • Fair adjustment methods are key to a stable and equitable healthcare market.