Data transformations to improve the performance of health plan payment methods

B-Tier
Journal: Journal of Health Economics
Year: 2019
Volume: 66
Issue: C
Pages: 195-207

Authors (4)

Bergquist, Savannah L. (not in RePEc) Layton, Timothy J. (Harvard University) McGuire, Thomas G. (not in RePEc) Rose, Sherri (not in RePEc)

Score contribution per author:

0.503 = (α=2.01 / 4 authors) × 1.0x B-tier

α: calibrated so average coauthorship-adjusted count equals average raw count

Abstract

The conventional method for developing health care plan payment systems uses observed data to study alternative algorithms and set incentives for the health care system. In this paper, we take a different approach and transform the input data rather than the algorithm, so that the data used reflect the desired spending levels rather than the observed spending levels. We present a general economic model that incorporates the previously overlooked two-way relationship between health plan payment and insurer actions. We then demonstrate our systematic approach for data transformations in two Medicare applications: underprovision of care for individuals with chronic illnesses and health care disparities by geographic income levels. Empirically comparing our method to two other common approaches shows that the “side effects” of these approaches vary by context, and that data transformation is an effective tool for addressing misallocations in individual health insurance markets.

Technical Details

RePEc Handle
repec:eee:jhecon:v:66:y:2019:i:c:p:195-207
Journal Field
Health
Author Count
4
Added to Database
2026-01-25