Michel Oskam, Richard C. van Kleef, René C. J. A. van Vliet
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引用次数: 0
Abstract
Many regulated health insurance markets with community-rated premiums rely on risk adjustment (RA) to mitigate insurer-incentives to risk select. However, insurers remain typically undercompensated for chronically ill enrollees. We use historical data on health spending and risk adjuster information to identify individuals undercompensated by the Dutch RA model of 2021 and find a selective group (1% of the population) with an average annual undercompensation of €6,050. We supplement the RA model with a risk sharing modality called high-risk pooling (HRP) to organize residual-based compensations towards insurers for the identified group to reduce the mean undercompensation to zero. The effects are evaluated on subgroups defined by chronic disease, finding a 42% reduction of their average undercompensation. Therefore, through compensating 1% of the population, the insurer-incentives to select against chronically ill individuals substantially diminish. These results are compared to outlier-risk sharing (reinsurance), proving HRP to be more effective at reducing selection incentives.
期刊介绍:
The Journal of Risk and Insurance (JRI) is the premier outlet for theoretical and empirical research on the topics of insurance economics and risk management. Research in the JRI informs practice, policy-making, and regulation in insurance markets as well as corporate and household risk management. JRI is the flagship journal for the American Risk and Insurance Association, and is currently indexed by the American Economic Association’s Economic Literature Index, RePEc, the Social Sciences Citation Index, and others. Issues of the Journal of Risk and Insurance, from volume one to volume 82 (2015), are available online through JSTOR . Recent issues of JRI are available through Wiley Online Library. In addition to the research areas of traditional strength for the JRI, the editorial team highlights below specific areas for special focus in the near term, due to their current relevance for the field.