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Risk Adjustment

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Health Insurance Exchanges

January 1, 2009 | Report

This paper analyzes whether Congress can legislate a health insurance mandate and the potential legal challenges that might arise, given such a mandate.

Health Risk Appraisals

September 1, 2009 | Journal Article

Risk appraisals might influence employees' health behavior, but they're not the entire answer. In this paper the authors explore the potential role of health risk appraisals as a tool for managing health care quality and costs in employer-sponsored insurance.

Risk Selection and Risk Adjustment

June 1, 2009 | Journal Article

This article describes underlying problems in the markets for small group and individual insurance appraises current methods of subsidizing insurance for high-risk individuals and discusses how risk adjustment addresses conflicts between the group and individual insurance markets.

Risk-Adjustment Approach to Compensating Health Care Plans More Appropriately for Serving Chronically Ill People

January 1, 2003 | Program Result Report

From 1997 to 2001, researchers at the Institute for Health Policy Studies at the University of California, San Francisco, conducted a two-phase study to test the hypothesis that risk adjustment could be improved by removing patients with high-cost chronic conditions from the general risk pool and assessing their risk by analysis of detailed clinical information.

California Finds a Prescription to Make Health Insurance Premiums Equitable

January 1, 2001 | Program Result Report

In 1995 and 1996, the California Managed Risk Medical Insurance Board, Sacramento, Calif., developed a risk-adjustment mechanism that was applied to small employer group health insurance purchasers in the Health Insurance Plan of California (HIPC), the first statewide health insurance purchasing cooperative for small employers (three to 50 employees).

Should Government Encourage Use of Market Forces in Spreading Health Insurance Risks?

January 1, 2001 | Program Result Report

During 1994 and 1995, investigators at Harvard University School of Public Health analyzed the high-risk auto insurance market, secondary mortgage markets, and the futures and options markets to determine whether these sectors of the insurance market offer lessons for the health sector. The project looked specifically at how these markets spread risk.

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