全球智库信息集成服务系统(G2TT): Assessing Incentives for Adverse Selection in Health Plan Payment Systems

G2TT

来源类型	Working Paper
规范类型	报告
DOI	10.3386/w21531
来源ID	Working Paper 21531
	Assessing Incentives for Adverse Selection in Health Plan Payment Systems
	Timothy J. Layton; Randall P. Ellis; Thomas G. McGuire
发表日期	2015-09-07
出版年	2015
语种	英语
摘要	Health insurance markets face two forms of adverse selection problems. On the demand side, adverse selection leads to plan price distortions and inefficient sorting of consumers across health plans. On the supply side, adverse selection creates incentives for plans to inefficiently distort benefits to attract profitable enrollees. These problems can be addressed by features of health plan payment systems such as reinsurance, risk adjustment, and premium categories. In this paper, we develop Harberger- type measures of the efficiency consequences of price and benefit distortions under a given payment system. Our measures are valid, that is, based on explicit economic models of adverse selection. Our measures are complete, in that they are able to incorporate multiple features of plan payment systems. Finally, they are practical, in that they are based on the ex ante data available to regulators and researchers during the design phase of payment system development, prior to observing actual insurer and consumer behavior. After developing the measures, we illustrate their use by comparing the performance of the payment system planned for implementation in the ACA Marketplaces in 2017 to several policy alternatives. We show that, in protecting against both types of selection problems, a payment system that incorporates reinsurance and prospective risk adjustment out-performs the planned payment system which includes only concurrent risk adjustment.
主题	Health, Education, and Welfare ; Health
URL	https://www.nber.org/papers/w21531
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/579206
推荐引用方式 GB/T 7714	Timothy J. Layton,Randall P. Ellis,Thomas G. McGuire. Assessing Incentives for Adverse Selection in Health Plan Payment Systems. 2015.