The practice of risk adjustment.
This article focuses on risk adjustment under health care reform. It examines reasons for risk adjustment, how those reasons affect the method of adjustment, and practical issues that arise in the process of adjusting for risk. The paper concludes that adjusting payments to health plans makes the most sense. It advocates a risk adjustment agency that is regionally based and supportive of the public good. For risk adjustment to work, there must be a well-defined market and barriers to entry and exit.
Bowen
B
B
Kaiser Permanente, Oakland, CA 94612, USA.
D000206:Actuarial Analysis; D005249:Fees and Charges; D018166:Health Care Reform; D007342:Insurance Benefits; D015273:Insurance Selection Bias; D007348:Insurance, Health / Q000191:economics; D009042:Motivation; D018570:Risk Assessment; D014481:United States