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Results for “Insurance Selection Bias”

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PubMedDate not supplied

Community rating: an idea whose time has come (again).

The 20-year movement away from community rating of health insurance premiums in favor of experience rating has produced extreme inequities in the availability and affordability of health insurance coverage in the U.S. Current rating practices also have contributed to a rapid shift among employers to self-insure, thus allowing them to rewrite their benefit plans. By returning to a community rating system, the nation would eliminate many of these current market distortions.

Actuarial Analysis↗
PubMedDate not supplied

Taking the first step toward system reform.

Small companies and individual Americans have an extraordinarily difficult time finding health insurance they can afford. And, even when they do, annual premium increases quickly force them to shop for a new policy. Reforms of the small market insurance field should include requiring insurers to sell a policy to anyone who wants to buy one; requiring insurers, after six months, to cover all costs incurred because of preexisting medical conditions; and regulating annual premium increases. Two standard "MEDPLANS" would be offered at prices ranging from $75 to $100 a month.

Cost Control↗
PubMed1994

The role of risk adjustment in the assessment of medical practices in managed care.

As reliance on managed care to control the cost of health care in the United States grows, clinicians and managers will come under increasing competitive and regulatory pressure to identify and adopt the strategies and interventions that are not only most economical but that also best improve the health of the populations served. Explicit criteria will be embodied in public performance reports. Clearly, in comparing the performance of firms and of individuals who provide health care, disparities in risk among the patient populations will have to be compensated.

Actuarial Analysis↗
PubMed1995

Going for the Gold.

J. Patrick Rooney, the chairman of Golden Rule Insurance Co., has an idea that he says will curb health care spending--and make money for his company. Newt Gingrich and other congressional Republicans appear sold on it.

Cost Control↗