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Risk adjustment, risk sharing and premium regulation in health insurance markets : theory and practice

Author: Thomas G McGuire; Richard van Kleef
Publisher: London : Academic Press, [2018] ©2018
Edition/Format:   eBook : Document : EnglishView all editions and formats
Summary:
'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  Read more...
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Genre/Form: Electronic books
Additional Physical Format: Print version:
Risk adjustment, risk sharing and premium regulation in health insurance markets.
London, United Kingdom : Academic Press, an imprint of Elsevier, [2018]
(OCoLC)1020032331
Material Type: Document, Internet resource
Document Type: Internet Resource, Computer File
All Authors / Contributors: Thomas G McGuire; Richard van Kleef
ISBN: 9780128113264 012811326X
OCLC Number: 1048402961
Description: 1 online resource
Contents: Regulated competition in health insurance markets : paradigms and ongoing issues / Thomas G. McGuire and Richard C. van Kleef --
Premium regulation, risk equalization, risk sharing, and subsidies : effects on affordability and efficiency / Richard C. van Kleef, Frederik T. Schut and Wynand P.M.M. van de Ven --
Risk adjustment for health plan payment / Randall P. Ellis, Bruno Martins and Sherri Rose --
Risk sharing / Thomas G. McGuire and Richard C. van Kleef --
Evaluating the performance of health plan payment systems / Timothy J. Layton, Randall P. Ellis, Thomas G. McGuire and Richard C. van Kleef --
Health plan payment in Australia / Francesco Paolucci, Ana R. Sequeira, Ayman Fouda and Andrew Matthews --
Risk adjustment in Belgium : why and how to introduce socioeconomic variables in health plan payment / Erik Schokkaert, Joeri Guillaume and Carine van de Voorde --
Health plan payment in Chile / Carolina Velasco, Josefa Henríquez and Francesco Paolucci --
Health insurance and payment system reform in China / Julie Shi and Gordon Liu --
Health plan payment in Colombia / Sebastian Bauhoff, Iván Rodríguez-Bernate, Dirk Göpffarth, Ramiro Guerrero, Inés Galindo-Henriquez and Félix Nates --
Health plan payment in Germany / Jürgen Wasem, Florian Buchner, Gerald Lux and Sonja Schillo --
Health plan payment in Ireland / John Armstrong --
Regulated competition and health plan payment under the national health insurance law in Israel : the unfinished story / Shuli Brammli-Greenberg, Jacob Glazer and Amir Shmueli --
Health plan payment in the Netherlands / Richard C. van Kleef, Frank Eijkenaar, René C.J.A. van Vliet and Wynand P.M.M. van de Ven --
Health plan payment in the Russian Federation / Igor Sheiman --
Health plan payment in Switzerland / Christian P.R. Schmid, Konstantin Beck and Lukas Kauer --
Health plan payment in US marketplaces : regulated competition with a weak mandate / Timothy J. Layton, Ellen Montz and Mark Shepard --
Health plan payment in Medicaid managed care : a hybrid model of regulated competition / Timothy J. Layton, Alice Ndikumana and Mark Shepard --
Medicare Advantage : regulated competition in the shadow of a public option / Thomas G. McGuire and Joseph P. Newhouse.
Responsibility: edited by Thomas G. McGuire, Richard C. van Kleef.

Abstract:

'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. --

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