Scope and Incentives for Risk Selection in Health Insurance Markets With Regulated Competition: A Conceptual Framework and International Comparison.
Med Care Res Rev
; 81(3): 175-194, 2024 Jun.
Article
em En
| MEDLINE
| ID: mdl-38284550
ABSTRACT
In health insurance markets with regulated competition, regulators face the challenge of preventing risk selection. This paper provides a framework for analyzing the scope (i.e., potential actions by insurers and consumers) and incentives for risk selection in such markets. Our approach consists of three steps. First, we describe four types of risk selection (a) selection by consumers in and out of the market, (b) selection by consumers between high- and low-value plans, (c) selection by insurers via plan design, and (d) selection by insurers via other channels such as marketing, customer service, and supplementary insurance. In a second step, we develop a conceptual framework of how regulation and features of health insurance markets affect the scope and incentives for risk selection along these four dimensions. In a third step, we use this framework to compare nine health insurance markets with regulated competition in Australia, Europe, Israel, and the United States.
Palavras-chave
Texto completo:
1
Temas:
ECOS
/
Aspectos_gerais
/
Estado_mercado_regulacao
Bases de dados:
MEDLINE
Assunto principal:
Competição Econômica
/
Seguro Saúde
Tipo de estudo:
Etiology_studies
/
Risk_factors_studies
Limite:
Humans
País/Região como assunto:
America do norte
/
Asia
/
Europa
/
Oceania
Idioma:
En
Revista:
Med Care Res Rev
Assunto da revista:
PESQUISA EM SERVICOS DE SAUDE
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Holanda