ArticleThe European journal of health economics : HEPAC : health economics in prevention and care2022
Should administrative costs in health insurance be included in the risk-equalization? An analysis of five countries.
Article in The European journal of health economics : HEPAC : health economics in prevention and care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed.
- Exploration of using constrained regression in Germany's morbidity-based risk adjustment.The European journal of health economics : HEPAC : health economics in prevention and care · 2026Article
- Key indicators for evaluating Iran's health insurance performance.Health economics review · 2025Article
- The goal of risk equalization in regulated competitive health insurance markets.The European journal of health economics : HEPAC : health economics in prevention and care · 2023Article
- Trends in Medicaid Administrative Expenditures During the COVID-19 Public Health Emergency.Inquiry : a journal of medical care organization, provision and financingArticle
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7 authors.
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Abstract
Most countries that apply risk-equalization in their health insurance market(s) perform risk-equalization on medical claims but do not include other components of the insurance premium, such as administrative costs. Using fixed effects panel regressions from individual insurers in Australia, Germany, the Netherlands, Switzerland, and the US, we find evidence that health insurers with a high morbidity population on average have higher administrative costs. We argue that administrative costs should also be included in risk-equalization and we show that such equalization results in additional equalization payments nontrivial in size. Using examples from Germany and the US, we show how in practice policymakers can include administrative costs in risk-equalization. We are skeptical about applying risk-equalization to other components of the insurance premium, such as profits or costs related to solvency requirements of insurers.
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