Risk Adjustment Risk Sharing And Premium Regulation In Health Insurance Markets

Author : Thomas G. McGuire
Publisher : Academic Press
ISBN 13 : 012811326X
Total Pages : 648 pages
Book Rating : 4.64/5 ( download)

DOWNLOAD NOW!

Download or read book Risk Adjustment, Risk Sharing and Premium Regulation in Health Insurance Markets written by Thomas G. McGuire and published by Academic Press. This book was released on 2018-08-06 with total page 648 pages. Available in PDF, EPUB and Kindle. Book excerpt: Risk Adjustment, Risk Sharing and Premium Regulation in Health Insurance Markets: Theory and Practice describes the goals, design and evaluation of health plan payment systems. Part I contains 5 chapters discussing the role of health plan payment in regulated health insurance markets, key aspects of payment design (i.e. risk adjustment, risk sharing and premium regulation), and evaluation methods using administrative data on medical spending. Part II contains 14 chapters describing the health plan payment system in 14 countries and sectors around the world, including Australia, Belgium, Chile, China, Columbia, Germany, Ireland, Israel, the Netherlands, Russia, Switzerland and the United States. Authors discuss the evolution of these payment schemes, along with ongoing reforms and key lessons on the design of health plan payment. Provides a conceptual toolkit that describes the goals, design and evaluation of health plan payment systems in the context of policy paradigms, such as efficiency, affordability, fairness and avoidance of risk selection Brings together international experience from many different countries that apply regulated competition in different ways Delivers a practical toolkit for the evaluation of health plan payment modalities from the standpoint of efficiency and fairness

Author : Joel C. Cantor
Publisher : Routledge
ISBN 13 : 0415651956
Total Pages : 193 pages
Book Rating : 4.50/5 ( download)

DOWNLOAD NOW!

Download or read book State Health Insurance Market Reform written by Joel C. Cantor and published by Routledge. This book was released on 2012-09-25 with total page 193 pages. Available in PDF, EPUB and Kindle. Book excerpt: In this volume, leading American health economists provide a critical assessment of the current state of knowledge of insurance market reform that is accessible to both policy-makers and researchers.

Author : Jacob Glazer
Publisher : World Scientific Publishing Company
ISBN 13 : 9813202882
Total Pages : 208 pages
Book Rating : 4.87/5 ( download)

DOWNLOAD NOW!

Download or read book Models of Health Plan Payment and Quality Reporting written by Jacob Glazer and published by World Scientific Publishing Company. This book was released on 2016-12-22 with total page 208 pages. Available in PDF, EPUB and Kindle. Book excerpt: The book pulls together a series of articles by the authors that initiated the research areas of "optimal risk adjustment" and "optimal quality reporting." The papers present the basic theoretical models and link them to empirical application. Design of health insurance premiums to achieve efficient and fair outcomes is also covered. The chapters in the book also cover the intellectual development of approaches to health insurance regulation, beginning with more abstract models to those with explicit empirical and policy applications.

Author : Rudy C. Douven
Publisher :
ISBN 13 :
Total Pages : 56 pages
Book Rating : 4.43/5 ( download)

DOWNLOAD NOW!

Download or read book Regulated Competition in Health Insurance Markets written by Rudy C. Douven and published by . This book was released on 2000 with total page 56 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Author : Mark A. Hall
Publisher : American Enterprise Institute
ISBN 13 : 9780844738628
Total Pages : 128 pages
Book Rating : 4.2X/5 ( download)

DOWNLOAD NOW!

Download or read book Reforming Private Health Insurance written by Mark A. Hall and published by American Enterprise Institute. This book was released on 1994 with total page 128 pages. Available in PDF, EPUB and Kindle. Book excerpt: Between 1987 and 1991, the portion of Americans covered by individually purchased health insurance dropped 40per cent. Assuming the US will continue to rely on private financing for health care, the author clarifies benefits to society from an efficient health insurance market.

Author : Institute of Medicine
Publisher : National Academies Press
ISBN 13 : 0309048273
Total Pages : 381 pages
Book Rating : 4.79/5 ( download)

DOWNLOAD NOW!

Download or read book Employment and Health Benefits written by Institute of Medicine and published by National Academies Press. This book was released on 1993-02-01 with total page 381 pages. Available in PDF, EPUB and Kindle. Book excerpt: The United States is unique among economically advanced nations in its reliance on employers to provide health benefits voluntarily for workers and their families. Although it is well known that this system fails to reach millions of these individuals as well as others who have no connection to the work place, the system has other weaknesses. It also has many advantages. Because most proposals for health care reform assume some continued role for employers, this book makes an important contribution by describing the strength and limitations of the current system of employment-based health benefits. It provides the data and analysis needed to understand the historical, social, and economic dynamics that have shaped present-day arrangements and outlines what might be done to overcome some of the access, value, and equity problems associated with current employer, insurer, and government policies and practices. Health insurance terminology is often perplexing, and this volume defines essential concepts clearly and carefully. Using an array of primary sources, it provides a store of information on who is covered for what services at what costs, on how programs vary by employer size and industry, and on what governments doâ€"and do not doâ€"to oversee employment-based health programs. A case study adapted from real organizations' experiences illustrates some of the practical challenges in designing, managing, and revising benefit programs. The sometimes unintended and unwanted consequences of employer practices for workers and health care providers are explored. Understanding the concepts of risk, biased risk selection, and risk segmentation is fundamental to sound health care reform. This volume thoroughly examines these key concepts and how they complicate efforts to achieve efficiency and equity in health coverage and health care. With health care reform at the forefront of public attention, this volume will be important to policymakers and regulators, employee benefit managers and other executives, trade associations, and decisionmakers in the health insurance industry, as well as analysts, researchers, and students of health policy.

Author : White House Task Force on Health Risk Pooling (U.S.)
Publisher :
ISBN 13 :
Total Pages : 108 pages
Book Rating : 4.30/5 ( download)

DOWNLOAD NOW!

Download or read book Health Risk Pooling for Small-group Health Insurance written by White House Task Force on Health Risk Pooling (U.S.) and published by . This book was released on 1993 with total page 108 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Author : Christine Eibner
Publisher : Rand Corporation
ISBN 13 : 0833081241
Total Pages : 117 pages
Book Rating : 4.47/5 ( download)

DOWNLOAD NOW!

Download or read book The Affordable Care Act and Health Insurance Markets written by Christine Eibner and published by Rand Corporation. This book was released on 2013-08-29 with total page 117 pages. Available in PDF, EPUB and Kindle. Book excerpt: In this report, the authors estimate the effects of the Affordable Care Act on health insurance enrollment and premiums for ten states (Florida, Kansas, Louisiana, Minnesota, New Mexico, North Dakota, Ohio, Pennsylvania, South Carolina, and Texas) and for the nation overall, with a focus on outcomes in the nongroup and small group markets.

Author : Katherine Swartz
Publisher : Russell Sage Foundation
ISBN 13 : 1610445201
Total Pages : 220 pages
Book Rating : 4.07/5 ( download)

DOWNLOAD NOW!

Download or read book Reinsuring Health written by Katherine Swartz and published by Russell Sage Foundation. This book was released on 2006-05-11 with total page 220 pages. Available in PDF, EPUB and Kindle. Book excerpt: America's current system of health insurance, which relies almost exclusively on employer-sponsored coverage, is in danger of collapse, and this problem is not limited to the poor and working class. An increasing number of middle class Americans do not have employer-provided insurance and—due to skyrocketing premiums—cannot afford to purchase coverage for themselves. Reinsuring Health, by economist Katherine Swartz, examines this growing national crisis and outlines a concrete plan to make health insurance accessible and affordable for all Americans. Reinsuring Health documents why the number of uninsured Americans—now 45.5 million people—has grown in the last twenty-five years. Swartz focuses on how labor market changes—such as the decline of domestic manufacturing, decreased unionization, and the growth of non-standard work arrangements—have led U.S. employers to retreat from providing health insurance for their workers. These trends, combined with the increasing costs of medical care, have led to an explosion in health insurance premiums and a decline in coverage, particularly among the middle-class. Since those who seek insurance as individuals are generally most likely to need health care, private insurers charge higher premiums in the individual (non-group) markets than to people who obtain group insurance. This makes individual health insurance less attractive to the young and increasingly unaffordable for middle-class Americans. Similarly, insurers charge higher per person (or per family) premiums to small firms than to large companies, so many small firms do not sponsor coverage for their employees. Reinsuring Health shows how these problems can be overcome if the federal government provides a new reinsurance program which would protect insurance companies that provide small group and individual health insurance against the possibility that their policy-holders will incur very high medical expenses. By assuming some of the risk that people will face extremely costly medical bills, the government will make insurers less hesitant to offer coverage to high-risk individuals, and will help drive down premiums for others. Reinsuring Health demonstrates that this form of government reinsurance has worked in the past, helping to establish smooth running private markets for catastrophe insurance and secondary mortgages. Today, growing numbers of middle class Americans lack health insurance. Protection against the possibility of falling ill or getting hurt and having to pay extraordinary health care bills should not be a luxury available only to the very rich and the very poor. Reinsuring Health proposes a straightforward solution that would bring health insurance back within the reach of the increasing ranks of the uninsured, particularly those who are in the middle class.

Author : Institute of Medicine
Publisher : National Academies Press
ISBN 13 : 0309104726
Total Pages : 619 pages
Book Rating : 4.22/5 ( download)

DOWNLOAD NOW!

Download or read book The Future of Disability in America written by Institute of Medicine and published by National Academies Press. This book was released on 2007-10-24 with total page 619 pages. Available in PDF, EPUB and Kindle. Book excerpt: The future of disability in America will depend on how well the U.S. prepares for and manages the demographic, fiscal, and technological developments that will unfold during the next two to three decades. Building upon two prior studies from the Institute of Medicine (the 1991 Institute of Medicine's report Disability in America and the 1997 report Enabling America), The Future of Disability in America examines both progress and concerns about continuing barriers that limit the independence, productivity, and participation in community life of people with disabilities. This book offers a comprehensive look at a wide range of issues, including the prevalence of disability across the lifespan; disability trends the role of assistive technology; barriers posed by health care and other facilities with inaccessible buildings, equipment, and information formats; the needs of young people moving from pediatric to adult health care and of adults experiencing premature aging and secondary health problems; selected issues in health care financing (e.g., risk adjusting payments to health plans, coverage of assistive technology); and the organizing and financing of disability-related research. The Future of Disability in America is an assessment of both principles and scientific evidence for disability policies and services. This book's recommendations propose steps to eliminate barriers and strengthen the evidence base for future public and private actions to reduce the impact of disability on individuals, families, and society.