Formal Risk Adjustment by Private Employers

This paper explores explanations for why few private employers have adopted formal risk adjustment. The lack of data, challenges of using highly imperfect signals, and absence of market power are not compelling explanations. Alternative strategies that reduce selection problems are clearly important...

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Main Author: Randall P. Ellis
Format: Article
Language:English
Published: SAGE Publishing 2001-08-01
Series:Inquiry: The Journal of Health Care Organization, Provision, and Financing
Online Access:https://doi.org/10.5034/inquiryjrnl_38.3.299
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author Randall P. Ellis
author_facet Randall P. Ellis
author_sort Randall P. Ellis
collection DOAJ
description This paper explores explanations for why few private employers have adopted formal risk adjustment. The lack of data, challenges of using highly imperfect signals, and absence of market power are not compelling explanations. Alternative strategies that reduce selection problems are clearly important. The central argument is that U.S. health markets are not in equilibrium, but rather are changing rapidly. Since many agents—consumers, employers, health plans, and providers—do not currently demand formal risk adjustment, it is not surprising that adoption has been slow. Recent changes in health plan markets may change the demand and accelerate future adoption.
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spelling doaj.art-901a31dde3a0469e8ac649bf29cff76e2022-12-22T01:26:52ZengSAGE PublishingInquiry: The Journal of Health Care Organization, Provision, and Financing0046-95802001-08-013810.5034/inquiryjrnl_38.3.299Formal Risk Adjustment by Private EmployersRandall P. EllisThis paper explores explanations for why few private employers have adopted formal risk adjustment. The lack of data, challenges of using highly imperfect signals, and absence of market power are not compelling explanations. Alternative strategies that reduce selection problems are clearly important. The central argument is that U.S. health markets are not in equilibrium, but rather are changing rapidly. Since many agents—consumers, employers, health plans, and providers—do not currently demand formal risk adjustment, it is not surprising that adoption has been slow. Recent changes in health plan markets may change the demand and accelerate future adoption.https://doi.org/10.5034/inquiryjrnl_38.3.299
spellingShingle Randall P. Ellis
Formal Risk Adjustment by Private Employers
Inquiry: The Journal of Health Care Organization, Provision, and Financing
title Formal Risk Adjustment by Private Employers
title_full Formal Risk Adjustment by Private Employers
title_fullStr Formal Risk Adjustment by Private Employers
title_full_unstemmed Formal Risk Adjustment by Private Employers
title_short Formal Risk Adjustment by Private Employers
title_sort formal risk adjustment by private employers
url https://doi.org/10.5034/inquiryjrnl_38.3.299
work_keys_str_mv AT randallpellis formalriskadjustmentbyprivateemployers