Risk Adjustment, Risk Sharing and Premium Regulation in Health Insurance Markets: Theory and Practice
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.
This volume is the first that brings together theory and practice of health plan payment in such a comprehensive and accessible way. The volume is a must-have for any researcher, policymaker, professional or student involved or interested in health policy and health plan payment in particular.