Risk Adjustment Risk Sharing and Premium Regulation in Health Insurance Markets

Risk Adjustment, Risk Sharing and Premium Regulation in Health Insurance Markets: Theory and Practice describes the goals, design and evaluation of health plan payment systems. Part I contains 5 chapters discussing the role of health plan payment in regulated health insurance markets, key aspects of payment design (i.e. risk adjustment, risk sharing and premium regulation), and evaluation methods using administrative data on medical spending. Part II contains 14 chapters describing the health plan payment system in 14 countries and sectors around the world, including Australia, Belgium, Chile, China, Columbia, Germany, Ireland, Israel, the Netherlands, Russia, Switzerland and the United States. Authors discuss the evolution of these payment schemes, along with ongoing reforms and key lessons on the design of health plan payment. Provides a conceptual toolkit that describes the goals, design and evaluation of health plan payment systems in the context of policy paradigms, such as efficiency, affordability, fairness and avoidance of risk selection Brings together international experience from many different countries that apply regulated competition in different ways Delivers a practical toolkit for the evaluation of health plan payment modalities from the standpoint of efficiency and fairness

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  • Author : Thomas G. McGuire
  • Publisher : Academic Press
  • Pages : 648 pages
  • ISBN : 012811326X
  • Rating : 4/5 from 21 reviews
CLICK HERE TO GET THIS BOOKRisk Adjustment Risk Sharing and Premium Regulation in Health Insurance Markets

Risk Adjustment, Risk Sharing and Premium Regulation in Health Insurance Markets

Risk Adjustment, Risk Sharing and Premium Regulation in Health Insurance Markets
  • Author : Thomas G. McGuire,Richard C. Van Kleef
  • Publisher : Academic Press
  • Release : 06 August 2018
GET THIS BOOKRisk Adjustment, Risk Sharing and Premium Regulation in Health Insurance Markets

Risk Adjustment, Risk Sharing and Premium Regulation in Health Insurance Markets: Theory and Practice describes the goals, design and evaluation of health plan payment systems. Part I contains 5 chapters discussing the role of health plan payment in regulated health insurance markets, key aspects of payment design (i.e. risk adjustment, risk sharing and premium regulation), and evaluation methods using administrative data on medical spending. Part II contains 14 chapters describing the health plan payment system in 14 countries and sectors around the

Epidemics and the Health of African Nations

Epidemics and the Health of African Nations
  • Author : MISTRA
  • Publisher : The Mapungubwe Institute for Strategic Reflection (MISTRA)
  • Release : 25 July 2019
GET THIS BOOKEpidemics and the Health of African Nations

News footage of disease in Africa is a familiar sight. Yet these outbreaks are often presented out of context, with no reference to the conditions that have triggered them. MISTRA’s new book, Epidemics and the Health of African Nations, aims to redress that. Researchers and practitioners from within the continent explore why Africa is so vulnerable to disease, and show how this vulnerability is closely linked to political and economic factors. They demonstrate how these same factors determine the

Handbook of Health Economics

Handbook of Health Economics
  • Author : A J. Culyer,J.P. Newhouse
  • Publisher : Elsevier
  • Release : 19 July 2000
GET THIS BOOKHandbook of Health Economics

The Handbook of Health Economics provide an up-to-date survey of the burgeoning literature in health economics. As a relatively recent subdiscipline of economics, health economics has been remarkably successful. It has made or stimulated numerous contributions to various areas of the main discipline: the theory of human capital; the economics of insurance; principal-agent theory; asymmetric information; econometrics; the theory of incomplete markets; and the foundations of welfare economics, among others. Perhaps it has had an even greater effect outside the

The Oxford Handbook of Health Economics

The Oxford Handbook of Health Economics
  • Author : Sherry Glied,Peter C. Smith
  • Publisher : Oxford University Press
  • Release : 07 April 2011
GET THIS BOOKThe Oxford Handbook of Health Economics

This book provides an engaging, comprehensive review of health economics, with a focus on policy implications in the developed and developing world. Authoritative, but non-technical, it stresses the wide reach of the discipline - across nations, health systems, and areas within health and medical care.

Private Health Insurance Premiums and Rate Reviews

Private Health Insurance Premiums and Rate Reviews
  • Author : Mark Newsom
  • Publisher : DIANE Publishing
  • Release : 01 April 2011
GET THIS BOOKPrivate Health Insurance Premiums and Rate Reviews

Health insur. premiums (HIP) have been trending up, while the value of coverage has trended down. Both admin. and medical costs continue to rise, but the rate of growth in these expenses slowed between 2008 and 2009. The rise in medical costs is primarily attributable to the price of services, not increased utilization. This report provides an overview of the concepts, regulation, and public data regarding private HIP. Contents of this report: (1) Intro.; (2) Drivers of HIP Increases: Health Benefits Exp.; Unit Prices;

Healthcare Risk Adjustment and Predictive Modeling

Healthcare Risk Adjustment and Predictive Modeling
  • Author : Ian G. Duncan
  • Publisher : ACTEX Publications
  • Release : 28 January 2021
GET THIS BOOKHealthcare Risk Adjustment and Predictive Modeling

This text is listed on the Course of Reading for SOA Fellowship study in the Group & Health specialty track. Healthcare Risk Adjustment and Predictive Modeling provides a comprehensive guide to healthcare actuaries and other professionals interested in healthcare data analytics, risk adjustment and predictive modeling. The book first introduces the topic with discussions of health risk, available data, clinical identification algorithms for diagnostic grouping and the use of grouper models. The second part of the book presents the concept of

Financing Health Care

Financing Health Care
  • Author : Mingshan Lu
  • Publisher : John Wiley & Sons
  • Release : 09 April 2008
GET THIS BOOKFinancing Health Care

Discussing international issues of health care financing, this is the first volume in a completely new public health book series, edited by the Institute of Health Economics (IHE) in Edmonton, Canada. Starting with various funding methods, the reference also features sections on different health care payment and purchasing mechanisms, as well as equity issues. Of interest to medical and allied health professionals, and those working in health care industries, insurance, and economics.

Encyclopedia of Health Economics

Encyclopedia of Health Economics
  • Author : Anonim
  • Publisher : Newnes
  • Release : 21 February 2014
GET THIS BOOKEncyclopedia of Health Economics

The Encyclopedia of Health Economics offers students, researchers and policymakers objective and detailed empirical analysis and clear reviews of current theories and polices. It helps practitioners such as health care managers and planners by providing accessible overviews into the broad field of health economics, including the economics of designing health service finance and delivery and the economics of public and population health. This encyclopedia provides an organized overview of this diverse field, providing one trusted source for up-to-date research and

Health Policy and the Uninsured

Health Policy and the Uninsured
  • Author : Catherine G. McLaughlin
  • Publisher : The Urban Insitute
  • Release : 28 January 2021
GET THIS BOOKHealth Policy and the Uninsured

The United States is unique in the industrialized world in the number of people without health insurance. In 2002, nearly 44 million Americans did not have health insurance coverage. Despite long-running study of this problem, the political debate on health insurance is often based on conventional wisdom and studies that haven't been integrated into a careful theoretical framework. In Health Policy and the Uninsured, leading experts in health policy survey the literature on this subject, synthesizing a wide range of health insurance

CBO's Analysis of the Major Health Care Legislation Enacted in March 2010

CBO's Analysis of the Major Health Care Legislation Enacted in March 2010
  • Author : Douglas W. Elmendorf
  • Publisher : DIANE Publishing
  • Release : 01 June 2011
GET THIS BOOKCBO's Analysis of the Major Health Care Legislation Enacted in March 2010

Statement about the CBO's analysis of the Patient Protection and Affordable Care Act and the provisions of the Health Care and Education Reconciliation Act of 2010 ("the Reconciliation Act,") that are related to health care. CBO and the staff of the Joint Comm. on Taxation have provided the Congress with extensive analyses of the legislation both before and after its enactment in March 2010. This statement summarizes the major results of those analyses -- in particular, the projected effects of those laws

Measuring and Modeling Health Care Costs

Measuring and Modeling Health Care Costs
  • Author : Ana Aizcorbe,Colin Baker,Ernst R. Berndt,David M. Cutler
  • Publisher : University of Chicago Press
  • Release : 05 March 2018
GET THIS BOOKMeasuring and Modeling Health Care Costs

Health care costs represent a nearly 18% of U.S. gross domestic product and 20% of government spending. While there is detailed information on where these health care dollars are spent, there is much less evidence on how this spending affects health. The research in Measuring and Modeling Health Care Costs seeks to connect our knowledge of expenditures with what we are able to measure of results, probing questions of methodology, changes in the pharmaceutical industry, and the shifting landscape of physician