Risk Adjustment, Risk Sharing and Premium Regulation in Health Insurance Markets PDF Download
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Author: Thomas G McGuire
Publisher: Academic Press
ISBN: 9780128113257
Category : Business & Economics
Languages : en
Pages : 0
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Book Description
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.
Author: Thomas G McGuire
Publisher: Academic Press
ISBN: 9780128113257
Category : Business & Economics
Languages : en
Pages : 0
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Book Description
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.
Author: Howard C. Kunreuther
Publisher: Cambridge University Press
ISBN: 0521845726
Category : Business & Economics
Languages : en
Pages : 343
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Book Description
This book examines the behavior of individuals at risk and insurance industry policy makers involved in selling, buying and regulation.
Author: Viviana A. Rotman Zelizer
Publisher: Columbia University Press
ISBN: 0231545428
Category : Social Science
Languages : en
Pages : 322
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Book Description
Life insurance—the promise of an insurer to pay a sum upon a person's death in exchange for a regular premium—is a bizarre enterprise. How can we monetize human life? Should we? What statistics do we use, what assumptions do we make, and what behavioral factors do we consider? First published in 1979, Morals and Markets Is a pathbreaking study exploring the development of life insurance in the United States. Viviana A. Rotman Zelizer combines economic history and a sociological perspective to advance a novel interpretation of the life insurance industry. The book pioneered a cultural approach to the analysis of morally controversial markets. Zelizer begins in the mid-nineteenth century with the rise of the life insurance industry, a contentious chapter in the history of American business. Life insurance was stigmatized at first, denounced in newspapers and condemned by religious leaders as an immoral and sacrilegious gamble on human life. Over time, the business became a widely praised arrangement to secure a family's future. How did life insurance overcome cultural barriers? As Zelizer shows, the evolution of the industry in the United States matched evolving attitudes toward death, money, family relations, property, and personal legacy.
Author: J. David Cummins
Publisher: Springer Science & Business Media
ISBN: 0387341633
Category : Business & Economics
Languages : en
Pages : 1000
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Book Description
Handbook of International Insurance: Between Global Dynamics and Local Contingencies analyzes key trends in the insurance industry in more than 15 important national insurance markets that represent over 90 percent of world insurance premiums. Well-known academics from Europe, the Americas and Asia examine their own national insurance markets, including the competitive structure, product and service innovations, and regulatory developments. The book provides academics and executives with an unprecedented range of information about today’s insurance markets. This book also provides important 'new' information on the evolution of the financial sector worldwide and comprehensive chapters on reinsurance, Lloyd’s of London, alternative risk transfer, South and East Asian insurance markets, and European insurance markets. Setting the stage is an overview chapter by the editors focusing on overall conclusions on globalization.
Author: Tamara Thompson
Publisher: Greenhaven Publishing LLC
ISBN: 0737771496
Category : Young Adult Nonfiction
Languages : en
Pages : 130
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Book Description
The Patient Protection and Affordable Care Act (ACA) was designed to increase health insurance quality and affordability, lower the uninsured rate by expanding insurance coverage, and reduce the costs of healthcare overall. Along with sweeping change came sweeping criticisms and issues. This book explores the pros and cons of the Affordable Care Act, and explains who benefits from the ACA. Readers will learn how the economy is affected by the ACA, and the impact of the ACA rollout.
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309083435
Category : Medical
Languages : en
Pages : 213
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Book Description
Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.
Author: Andreas Klasen
Publisher: John Wiley & Sons
ISBN: 1119167396
Category : Political Science
Languages : en
Pages : 628
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Book Description
Provides a state-of-the-art overview of international trade policy research The Handbook of Global Trade Policy offers readers a comprehensive resource for the study of international trade policy, governance, and financing. This timely and authoritative work presents contributions from a team of prominent experts that assess the policy implications of recent academic research on the subject. Discussions of contemporary research in fields such as economics, international business, international relations, law, and global politics help readers develop an expansive, interdisciplinary knowledge of 21st century foreign trade. Accessible for students, yet relevant for practitioners and researchers, this book expertly guides readers through essential literature in the field while highlighting new connections between social science research and global policy-making. Authoritative chapters address new realities of the global trade environment, global governance and international institutions, multilateral trade agreements, regional trade in developing countries, value chains in the Pacific Rim, and more. Designed to provide a well-rounded survey of the subject, this book covers financing trade such as export credit arrangements in developing economies, export insurance markets, climate finance, and recent initiatives of the World Trade Organization (WTO). This state-of-the-art overview: Integrates new data and up-to-date research in the field Offers an interdisciplinary approach to examining global trade policy Introduces fundamental concepts of global trade in an understandable style Combines contemporary economic, legal, financial, and policy topics Presents a wide range of perspectives on current issues surrounding trade practices and policies The Handbook of Global Trade Policy is a valuable resource for students, professionals, academics, researchers, and policy-makers in all areas of international trade, economics, business, and finance.
Author: Annette Hofmann
Publisher: VVW GmbH
ISBN: 3862981134
Category : Business & Economics
Languages : en
Pages : 191
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Book Description
The focus of this thesis is on consumer diversity. Incorporating consumer heterogeneity into economic analysis is well-established in industrial organization literature; this aspect is, however, often neglected in microeconomic insurance models. A first new approach lies in analyzing risk interdependencies. When risks are interdependent, an agent's decision to self-protect affects the loss probabilities faced by others. Due to these externalities, economic agents invest too little in prevention relative to the socially efficient level by ignoring marginal external costs or benefits conferred on others. We analyze an insurance market with externalities of loss prevention. It is shown in a model with heterogenous agents and imperfect information that a monopolistic insurer can achieve the social optimum by engaging in premium discrimination. An insurance monopoly reduces not only costs of risk selection, but may also play an important social role in loss prevention. This result can be empirically confirmed. We also deal with the impact of intermediation on insurance market transparency and performance. In a differentiated insurance market under imperfect information, uninformed consumers may become informed about product suitability by consulting an intermediary. We analyze current broker compensation systems: commissions and fees. While insurers' equilibrium profits are equivalent under both systems, social welfare under fees is first-best efficient. Both systems may offer the opportunity to increase profits via collusion. Under a commission system, collusion enables insurers to separate consumers into groups purchasing different contracts. Insurers may then extract additional rents from some consumers. This might explain why intermediaries tend to be compensated by insurers in practice. Finally, we study optimal monopoly pricing given imperfect information and heterogenous policyholders. Die in englischer Sprache verfasste Arbeit ist der mikroökonomischen Analyse von Versicherungsmärkten gewidmet. Zunächst werden einige wichtige theoretische Grundlagen der Versicherungsnachfragetheorie beschrieben. Eine zentrale Erweiterung des Basismodells stellen interdependente Risiken dar. Bestehen Risikointerdependenzen, so sind alle Maßnahmen, die die Schadenshäufigkeit reduzieren, mit positiven externen Effekten verbunden. Es wird gezeigt, dass im Gleichgewicht das realisierte Präventionsniveau unterhalb des optimalen Niveaus angesiedelt ist. Aufgrund der Externalitäten kommt es zu einem Marktversagen und nur ein Monopolversicherer kann eine differenzierte Prämienstruktur herbeiführen, die zum optimalen Präventionsniveau führt. Dieses Ergebnis kollidiert mit dem Ergebnis, dass wettbewerbliche Versicherungsmärkte zu einer höheren Gesamtwohlfahrt führen, es lässt sich jedoch empirisch stützen. Ein weiterer Schwerpunkt der Arbeit liegt auf unvollkommenen Versicherungsmärkten, wobei heterogene Versicherungsnachfrager mit unterschiedlichen Produktpräferenzen und Informationskosten unterstellt werden. In einem solchen Markt erhöhen Versicherungsvermittler die Markttransparenz und damit auch die Gewinne der Versicherer. Im Mittelpunkt steht die Analyse verschiedener Vergütungsformen der Vermittler. Ein Vergütungssystem auf Basis von Beratungshonoraren ist einem Provisionssystem aus wohlfahrtsökonomischer Perspektive vorzuziehen. Aus Sicht der Versicherer kehrt sich dieses Ergebnis allerdings um, sobald es zur Kollusion zwischen Versicherern und Vermittlern kommt. Der letzte Schwerpunkt liegt in der Analyse einer optimalen Preispolitik eines Versicherungsmonopolisten bei heterogenen Nachfragern, die sich durch ihre Risikopräferenzen und damit ihre individuelle Zahlungsbereitschaft für Versicherungen unterscheiden.
Author: Joel C. Cantor
Publisher: Routledge
ISBN: 0415651956
Category : Business & Economics
Languages : en
Pages : 193
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Book Description
In this volume, leading American health economists provide a critical assessment of the current state of knowledge of insurance market reform that is accessible to both policy-makers and researchers.
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
ISBN: 030946921X
Category : Medical
Languages : en
Pages : 161
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Book Description
The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.
