New Health and Society Data Have Been Reported by S. Schillo and Co-Authors [High cost pool or high cost groups-How to handle high(est) cost cases in…

New Health and Society Data Have Been Reported by S. Schillo and Co-Authors [High cost pool or high cost groups-How to handle high(est) cost cases in a risk adjustment mechanism?]

By a News Reporter-Staff News Editor at Health & Medicine Week -- Current study results on Health and Medicine have been published. According to news reporting out of Essen, Germany, by NewsRx editors, research stated, "Competitive social health insurance systems (at least) in Western Europe have implemented systems of morbidity based risk adjustment to set a level playing field for insurers. However, many high cost insured still are heavily underfunded despite risk adjustment, leaving incentives for risk selection."

Our news journalists obtained a quote from the research, "In most of these health care systems, there is an ongoing debate about how to deal with such underpaid high cost cases. This study develops four distinct concepts by adding variables to risk adjustment or by setting up a high cost pool for underpaid insured besides the risk adjustment system. Their features, incentives and distributional effects are discussed. With a data set of 6 million insured, performance is demonstrated for Germany. All models achieve a substantial improvement in model fit, measured in terms of R-2 as well as CPM."

According to the news editors, the research concluded: "As the results of the various models are different in different dimensions, the trade-offs that have to be dealt with and should be addressed, when implementing a model to reduce underfunding of high cost cases."

For more information on this research see: High cost pool or high cost groups-How to handle high(est) cost cases in a risk adjustment mechanism? Health Policy, 2016;120(2):141-147. Health Policy can be contacted at: Elsevier Ireland Ltd, Elsevier House, Brookvale Plaza, East Park Shannon, Co, Clare, 00000, Ireland. (Elsevier - www.elsevier.com; Health Policy - www.journals.elsevier.com/health-policy/)

Our news journalists report that additional information may be obtained by contacting S. Schillo, Hlth Econ Center CINCH, Essen, Germany. Additional authors for this research include G. Lux, J. Wasem and F. Buchner (see also Health and Medicine).

Keywords for this news article include: Essen, Europe, Germany, Health and Medicine

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