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Selection Incentives for Health Insurers in the Presence of Sophisticated Risk Adjustment.
van Kleef, Richard C; Eijkenaar, Frank; van Vliet, René C J A.
Afiliación
  • van Kleef RC; Erasmus University Rotterdam, Rotterdam, Netherlands.
  • Eijkenaar F; Erasmus University Rotterdam, Rotterdam, Netherlands.
  • van Vliet RCJA; Erasmus University Rotterdam, Rotterdam, Netherlands.
Med Care Res Rev ; 77(6): 584-595, 2020 12.
Article en En | MEDLINE | ID: mdl-30704337
This article analyzes selection incentives for insurers in the Dutch basic health insurance market, which operates with community-rated premiums and sophisticated risk adjustment. Selection incentives result from the interplay of three market characteristics: possible actions by insurers, consumer response to these actions, and predictable variation in profitability of insurance contracts. After a qualitative analysis of the first two characteristics our primary objective is to identify the third. Using a combination of claims data (N = 16.8 million) and survey information (N = 387,195), we find substantial predictable variation in profitability. On average, people in good health are profitable, while those in poor health are unprofitable. We conclude that Dutch insurers indeed face selection incentives. A complete measure of selection incentives, however, captures the correlation between individual-level profitability and consumer response to insurer-actions. Obtaining insight in this correlation is an important direction for further research.
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Texto completo: 1 Base de datos: MEDLINE Asunto principal: Ajuste de Riesgo / Aseguradoras Tipo de estudio: Etiology_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Med Care Res Rev Asunto de la revista: PESQUISA EM SERVICOS DE SAUDE Año: 2020 Tipo del documento: Article País de afiliación: Países Bajos

Texto completo: 1 Base de datos: MEDLINE Asunto principal: Ajuste de Riesgo / Aseguradoras Tipo de estudio: Etiology_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Med Care Res Rev Asunto de la revista: PESQUISA EM SERVICOS DE SAUDE Año: 2020 Tipo del documento: Article País de afiliación: Países Bajos