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Optimal cost reimbursement of health insurers to reduce risk selection

✍ Scribed by Mathias Kifmann; Normann Lorenz


Publisher
John Wiley and Sons
Year
2011
Tongue
English
Weight
226 KB
Volume
20
Category
Article
ISSN
1057-9230

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✦ Synopsis


In the absence of a perfect risk adjustment scheme, reimbursing health insurers' costs can reduce risk selection in community-rated health insurance markets. In this paper, we develop a model in which insurers determine the cost efficiency of health care and have incentives for risk selection. We derive the optimal cost reimbursement function, which balances the incentives for cost efficiency and risk selection. For health cost data from a Swiss health insurer, we find that an optimal cost reimbursement scheme should reimburse costs only up to a threshold.