Risk Adjustment, Risk Sharing and Premium Regulation in Health Insurance Markets

2018 ◽  
2006 ◽  
Vol 7 (Supplement) ◽  
pp. 75-91 ◽  
Author(s):  
Jacob Glazer ◽  
Thomas G. McGuire

Abstract In many countries, competition among health plans or sickness funds raises issues of risk selection. Funds may discourage or encourage potential enrollees from joining, and these actions may have efficiency or fairness implications. This article reviews the experience in the U.S., and comments on the evidence for risk selection in Germany. There is little evidence that risk selection causes efficiency problems in Germany, but risk selection does lead to an inequality in contribution rates. A simple approach to equalizing contribution rates that does not involve risk adjustment is presented and discussed.


2011 ◽  
Vol 6 (1) ◽  
pp. 147-156 ◽  
Author(s):  
Wynand P. M. M. Van de Ven

AbstractIn this paper, we first deal with the rationale of risk adjustment and risk equalization in health insurance markets. Then we discuss the state of the art concerning the application of risk adjustment and risk equalization in practice. Finally, we focus on: What needs to be done?


2004 ◽  
Vol 23 (4) ◽  
pp. 167-175 ◽  
Author(s):  
Alan C. Monheit ◽  
Joel C. Cantor ◽  
Margaret Koller ◽  
Kimberley S. Fox

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