How profitable is risk selection? A comparison of four risk adjustment models

B-Tier
Journal: Health Economics
Year: 2002
Volume: 11
Issue: 2
Pages: 165-174

Authors (2)

Yujing Shen (not in RePEc) Randall P. Ellis (Boston University)

Score contribution per author:

1.005 = (α=2.01 / 2 authors) × 1.0x B-tier

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

Abstract

To mitigate selection triggered by capitation payments, risk‐adjustment models bring capitation payments closer on average to individuals' expected expenditure. We examine the maximum potential profit that plans could hypothetically gain by using their own private information to select low‐cost enrollees when payments are made using four commonly used risk adjustment models. Simulations using a privately insured sample suggest that risk selection profits remain substantial. The magnitude of potential profit varies according to the risk adjustment model and the private information plans can employ to identify profitable enrollees. Copyright © 2002 John Wiley & Sons, Ltd.

Technical Details

RePEc Handle
repec:wly:hlthec:v:11:y:2002:i:2:p:165-174
Journal Field
Health
Author Count
2
Added to Database
2026-01-25