A demand-side view of risk adjustment.

Inquiry

Division of Health Services Research and Policy, School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA.

Published: December 2001

This paper analyzes the efficient allocation of consumers to health plans. Specifically, we address the question of why employers that offer multiple health plans often make larger contributions to the premiums of the high-cost plans. Our perspective is that the subsidy for high-cost plans represents a form of demand-side risk adjustment that improves efficiency. Without such subsidies (and in the absence of formal risk adjustment), too few employees would choose the high-cost plans preferred by high-risk workers. We test the theory by estimating a model of the employer premium subsidy, using data from a survey of large public employers in 1994. Our empirical analysis shows that employers are more likely to subsidize high-cost plans when the benefits of risk adjustment are greater. The findings suggest that the premium subsidy can accomplish some of the benefits of formal risk adjustment.

Download full-text PDF

Source
http://dx.doi.org/10.5034/inquiryjrnl_38.3.280DOI Listing

Publication Analysis

Top Keywords

risk adjustment
20
high-cost plans
16
health plans
8
formal risk
8
premium subsidy
8
plans
6
risk
5
adjustment
5
demand-side view
4
view risk
4

Similar Publications

Radon Exposure and Gestational Diabetes.

JAMA Netw Open

January 2025

Department of Obstetrics and Gynecology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York.

Importance: Understanding environmental risk factors for gestational diabetes (GD) is crucial for developing preventive strategies and improving pregnancy outcomes.

Objective: To examine the association of county-level radon exposure with GD risk in pregnant individuals.

Design, Setting, And Participants: This multicenter, population-based cohort study used data from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be (nuMoM2b) cohort, which recruited nulliparous pregnant participants from 8 US clinical centers between October 2010 and September 2013.

View Article and Find Full Text PDF

Background: Diabetes is closely related to hypertension, and insulin resistance-related indices are novel metrics used to evaluate the risk of diabetes and cardiovascular diseases. This study aims to explore the relationships between the TyG index, METS-IR, TG/HDL-C, and HOMA-IR with hypertension.

Methods: Data from the NHANES spanning ten consecutive survey cycles from 1998 to 2018 were utilized, focusing on adults with complete blood pressure data and comprehensive information for calculating the TyG index, METS-IR, TG/HDL-C, and HOMA-IR.

View Article and Find Full Text PDF

Objective: Anemia, obstructive sleep apnea (OSA), and hypertension are common social health problems. They are interconnected. This study assessed the independent association of anemia and OSA with hypertension and the interaction between anemia and OSA on hypertension in the US population.

View Article and Find Full Text PDF

Objective: We aimed to evaluate the risks of death and cardiovascular death of different subtypes of masked hypertension, defined by either isolated daytime or nighttime blood pressure (BP) elevation, or both, compared with patients with normal both office and 24-h BP.

Methods: We selected 4999 patients with masked hypertension (normal office BP and elevated 24-h BP). They were divided in three different categories: isolated daytime masked hypertension (elevated daytime BP and normal nighttime BP, 800 patients), isolated nighttime masked hypertension (elevated nighttime BP and normal daytime BP, 1069 patients) and daytime and nighttime masked hypertension (elevation of both daytime and nighttime BP, 2989).

View Article and Find Full Text PDF

Background: Meta-analyses have suggested that the risk of cardiovascular disease events is significantly higher after a chronic obstructive pulmonary disease (COPD) exacerbation, but the populations at highest risk have not been well characterized to date.

Methods And Results: The authors analyzed the risk of atherosclerotic cardiovascular disease (ASCVD) hospitalizations after COPD hospitalization compared with before COPD hospitalization and patient factors associated with ASCVD hospitalizations after COPD hospitalization among 2 high-risk patient cohorts. The primary outcome was risk of an ASCVD hospitalization composite outcome (myocardial infarction, coronary artery bypass graft, percutaneous coronary intervention, stroke, transient ischemic accident) after COPD hospitalization relative to before COPD hospitalization.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!