Are health-based payments a feasible tool for addressing risk segmentation?
As they attempt to increase health insurance coverage and improve the efficiency of the market, researchers, policymakers, and health plan representatives have been addressing the issue of risk segmentation. Many risk assessment tools and risk-adjusted payment methodologies have been developed and demonstrated for a variety of populations and payers experiencing various market constraints. The evidence shows that risk-adjusted payments are feasible for most populations receiving acute care, while technical obstacles, political issues, and some research gaps remain.
Rogal
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Alpha Center, Washington DC 20036, USA.
Gauthier
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AK
D019981:Health Care Sector; D019458:Insurance Coverage / Q000458:organization & administration*; D015273:Insurance Selection Bias; D007348:Insurance, Health / Q000191:economics*; D008389:Marketing of Health Services; D011050:Policy Making; D012052:Reimbursement, Incentive / Q000458:organization & administration; D012308:Risk Management; D014481:United States