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 MISTRA
  • Publisher : African Books Collective
  • 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

Private Health Insurance and the European Union

Private Health Insurance and the European Union
  • Author : Cyril Benoît,Marion Del Sol,Philippe Martin
  • Publisher : Springer Nature
  • Release : 03 December 2020
GET THIS BOOKPrivate Health Insurance and the European Union

Research has paid little attention to date on how European Union law and regulation affect both the public-private mix in healthcare and the organization of private health insurance as an industry. Filling this gap, this collective book provides insights on the political economy of EU insurance regulation, its impact on private health insurers and on its interactions with domestic healthcare policy-making in four countries. Assembling original contributions drafted by a multidisciplinary team, Private Health Insurance and the European Union offers

Price Setting and Price Regulation in Health Care

Price Setting and Price Regulation in Health Care
  • Author : OECD,World Health Organization,Barber Sarah L,Lorenzoni Luca,Ong Paul
  • Publisher : OECD Publishing
  • Release : 26 June 2019
GET THIS BOOKPrice Setting and Price Regulation in Health Care

The objectives of this study are to describe experiences in price setting and how pricing has been used to attain better coverage, quality, financial protection, and health outcomes. It builds on newly commissioned case studies and lessons learned in calculating prices, negotiating with providers, and monitoring changes. Recognising that no single model is applicable to all settings, the study aimed to generate best practices and identify areas for future research, particularly in low- and middle-income settings. The report and the

The Oxford Handbook of the Welfare State

The Oxford Handbook of the Welfare State
  • Author : Daniel Béland,Kimberly J. Morgan,Herbert Obinger,Christopher Pierson
  • Publisher : Oxford University Press
  • Release : 22 October 2021
GET THIS BOOKThe Oxford Handbook of the Welfare State

This is the much anticipated revised second edition of a volume that was welcomed at its first appearance as 'the most authoritative survey and critique of the welfare state yet published'. It is an indispensable one-volume guide to what modern states spend most of their time and money doing.

The Future of Disability in America

The Future of Disability in America
  • Author : Institute of Medicine,Board on Health Sciences Policy,Committee on Disability in America
  • Publisher : National Academies Press
  • Release : 24 October 2007
GET THIS BOOKThe Future of Disability in America

The future of disability in America will depend on how well the U.S. prepares for and manages the demographic, fiscal, and technological developments that will unfold during the next two to three decades. Building upon two prior studies from the Institute of Medicine (the 1991 Institute of Medicine's report Disability in America and the 1997 report Enabling America), The Future of Disability in America examines both progress and concerns about continuing barriers that limit the independence, productivity, and participation in community

Voluntary Health Insurance in Europe

Voluntary Health Insurance in Europe
  • Author : Anna Sagan,Sarah Thomson
  • Publisher : World Health Organization
  • Release : 21 July 2016
GET THIS BOOKVoluntary Health Insurance in Europe

No two markets for voluntary health insurance (VHI) are identical. All differ in some way because they are heavily shaped by the nature and performance of publicly financed health systems and by the contexts in which they have evolved. This volume contains short, structured profiles of markets for VHI in 34 countries in Europe. These are drawn from European Union member states plus Armenia, Iceland, Georgia, Norway, the Russian Federation, Switzerland and Ukraine. The book is aimed at policy-makers and researchers

Handbook of Health Economics

Handbook of Health Economics
  • Author : Mark V. Pauly,Thomas G. McGuire,Pedro Pita Barros
  • Publisher : Elsevier
  • Release : 01 January 2012
GET THIS BOOKHandbook of Health Economics

What new theories, evidence, and policies have shaped health economics in the 21st century? Editors Mark Pauly, Thomas McGuire, and Pedro Pita Barros assemble the expertise of leading authorities in this survey of substantive issues. In 16 chapters they cover recent developments in health economics, from medical spending growth to the demand for health care, the markets for pharmaceutical products, the medical workforce, and equity in health and health care. Its global perspective, including an emphasis on low and middle-income countries,

Managing Climate Risk in the U.S. Financial System

Managing Climate Risk in the U.S. Financial System
  • Author : Leonardo Martinez-Diaz,Jesse M. Keenan
  • Publisher : U.S. Commodity Futures Trading Commission
  • Release : 09 September 2020
GET THIS BOOKManaging Climate Risk in the U.S. Financial System

This publication serves as a roadmap for exploring and managing climate risk in the U.S. financial system. It is the first major climate publication by a U.S. financial regulator. The central message is that U.S. financial regulators must recognize that climate change poses serious emerging risks to the U.S. financial system, and they should move urgently and decisively to measure, understand, and address these risks. Achieving this goal calls for strengthening regulators’ capabilities, expertise, and data

Health-Care Utilization as a Proxy in Disability Determination

Health-Care Utilization as a Proxy in Disability Determination
  • Author : National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Health Care Services,Committee on Health Care Utilization and Adults with Disabilities
  • Publisher : National Academies Press
  • Release : 02 April 2018
GET THIS BOOKHealth-Care Utilization as a Proxy in Disability Determination

The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough

Moral Hazard in Health Insurance

Moral Hazard in Health Insurance
  • Author : Amy Finkelstein
  • Publisher : Columbia University Press
  • Release : 02 December 2014
GET THIS BOOKMoral Hazard in Health Insurance

Addressing the challenge of covering heath care expenses—while minimizing economic risks. Moral hazard—the tendency to change behavior when the cost of that behavior will be borne by others—is a particularly tricky question when considering health care. Kenneth J. Arrow’s seminal 1963 paper on this topic (included in this volume) was one of the first to explore the implication of moral hazard for health care, and Amy Finkelstein—recognized as one of the world’s foremost experts on

The Affordable Care Act

The Affordable Care Act
  • Author : Tamara Thompson
  • Publisher : Greenhaven Publishing LLC
  • Release : 02 December 2014
GET THIS BOOKThe Affordable Care Act

The Patient Protection and Affordable Care Act (ACA) was designed to increase health insurance quality and affordability, lower the uninsured rate by expanding insurance coverage, and reduce the costs of healthcare overall. Along with sweeping change came sweeping criticisms and issues. This book explores the pros and cons of the Affordable Care Act, and explains who benefits from the ACA. Readers will learn how the economy is affected by the ACA, and the impact of the ACA rollout.