ArticleJournal of health economics2018
Deriving risk adjustment payment weights to maximize efficiency of health insurance markets.
Article in Journal of health economics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed.
- Ex ante evaluation of risk adjustment models for prospective provider payment: a conceptual framework and empirical application.The European journal of health economics : HEPAC : health economics in prevention and care · 2026Article
- Cross-sectional analysis of accuracy versus interpretability in Medicare Advantage risk adjustment.Health policy OPEN · 2026Article
- Noninterruptive tool to support provider malnutrition documentation and minimize documentation queries.JAMIA open · 2025Article
- A critical review of the use of RThe European journal of health economics : HEPAC : health economics in prevention and care · 2025Review
- Setting incentives right with long-term risk adjustment.The European journal of health economics : HEPAC : health economics in prevention and care · 2025Article
- A Framework for the Design of Risk-Adjustment Models in Health care Provider Payment Systems.Medical care research and review : MCRR · 2025Review
- A framework for ex-ante evaluation of the potential effects of risk equalization and risk sharing in health insurance markets with regulated competition.Health economics review · 2024Review
- Pricing regulations in individual health insurance: Evidence from Medigap.Journal of health economics · 2023Article
- Improving diagnosis-based cost groups in the Dutch risk equalization model: the effects of a new clustering method and allowing for multimorbidity.International journal of health economics and management · 2023Article
- How to deal with persistently low/high spenders in health plan payment systems?Health economics · 2022Article
- Multivariable prediction models for health care spending using machine learning: a protocol of a systematic review.Diagnostic and prognostic research · 2022Article
- Use of past care markers in risk-adjustment: accounting for systematic differences across providers.The European journal of health economics : HEPAC : health economics in prevention and care · 2022Article
- Incorporating self-reported health measures in risk equalization through constrained regression.The European journal of health economics : HEPAC : health economics in prevention and care · 2020Article
- Data transformations to improve the performance of health plan payment methods.Journal of health economics · 2019Article
- Limitations of P-Values and R-squared for Stepwise Regression Building: A Fairness Demonstration in Health Policy Risk Adjustment.The American statistician · 2019Article
- The Comparative Advantage of Medicare Advantage.American journal of health economics · 2019Article
- Sample Selection for Medicare Risk Adjustment Due to Systematically Missing Data.Health services research · 2018Article
- Measuring efficiency of health plan payment systems in managed competition health insurance markets.Journal of health economics · 2017Article
- Achieving Mental Health Care Parity Might Require Changes In Payments And Competition.Health affairs (Project Hope) · 2016Article
- Selection in Health Insurance Markets and Its Policy Remedies.The journal of economic perspectives : a journal of the American Economic AssociationArticle
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
Risk-adjustment is critical to the functioning of regulated health insurance markets. To date, estimation and evaluation of a risk-adjustment model has been based on statistical rather than economic objective functions. We develop a framework where the objective of risk-adjustment is to minimize the efficiency loss from service-level distortions due to adverse selection, and we use the framework to develop a welfare-grounded method for estimating risk-adjustment weights. We show that when the number of risk adjustor variables exceeds the number of decisions plans make about service allocations, incentives for service-level distortion can always be eliminated via a constrained least-squares regression. When the number of plan service-level allocation decisions exceeds the number of risk-adjusters, the optimal weights can be found by an OLS regression on a straightforward transformation of the data. We illustrate this method with the data used to estimate risk-adjustment payment weights in the Netherlands (N = 16.5 million).
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.