Insolvency risk in health carriers: innovation, competition, and public protection.
This paper reviews the framework of regulatory and managerial devices that have evolved in response to the special dangers to the public posed by insolvency of health carriers. These devices include "prudential" measures designed to decrease the likelihood of insolvency, and measures to "protect enrollees" in the event that insolvency occurs nevertheless. It also reviews the current debate over how this framework should be adapted to new forms of risk-bearing entities, especially provider-sponsored networks engaged in direct contracting with purchasers of coverage. Parallels to solvency concerns in the banking industry are explored.
Akula
J L
JL
D016361:Bankruptcy / Q000331:legislation & jurisprudence*; D018166:Health Care Reform; D006279:Health Maintenance Organizations / Q000191:economics / Q000331:legislation & jurisprudence; D007343:Insurance Carriers / Q000191:economics* / Q000331:legislation & jurisprudence; D012306:Risk; D014481:United States