| 来源类型 | Working Paper |
| 规范类型 | 报告 |
| DOI | 10.3386/w20359 |
| 来源ID | Working Paper 20359 |
| Tradeoffs in the Design of Health Plan Payment Systems: Fit, Power and Balance | |
| Michael Geruso; Thomas G. McGuire | |
| 发表日期 | 2014-07-31 |
| 出版年 | 2014 |
| 语种 | 英语 |
| 摘要 | In many markets, including the new U.S. Exchanges, health insurance plans are paid by risk-adjusted capitation, in some markets combined with reinsurance and other payment mechanisms. This paper proposes three metrics for analyzing the insurer incentives embedded in these complex payment systems. We discuss fit, power and balance, each of which addresses a distinct market failure in health insurance. We implement these metrics in a study of Exchange payment systems with data similar to that used to develop the Exchange risk adjustment scheme and quantify the empirical tradeoffs among the metrics. We show that an essential tradeoff arises between the goals of limiting costs and limiting cream skimming because risk adjustment, which is aimed at discouraging cream-skimming, is in fact tied to costs. We find that a simple reinsurance system scores better on fit, power and balance than the risk adjustment scheme in use in the Exchanges. |
| 主题 | Public Economics ; Public Goods ; National Fiscal Issues ; Health, Education, and Welfare ; Health |
| URL | https://www.nber.org/papers/w20359 |
| 来源智库 | National Bureau of Economic Research (United States) |
| 引用统计 | |
| 资源类型 | 智库出版物 |
| 条目标识符 | http://119.78.100.153/handle/2XGU8XDN/578032 |
| 推荐引用方式 GB/T 7714 | Michael Geruso,Thomas G. McGuire. Tradeoffs in the Design of Health Plan Payment Systems: Fit, Power and Balance. 2014. |
| 条目包含的文件 | 条目无相关文件。 | |||||
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