Optimal cost reimbursement of health insurers to reduce risk selection
研究了在风险调整不完美时，如何设计最优成本补偿方案来平衡健康保险公司控制成本与减少风险选择的激励，并用瑞士数据发现补偿应设上限。
In the absence of a perfect risk adjustment scheme, reimbursing health insurers' costs can reduce risk selection in community-rated health insurance markets. In this paper, we develop a model in which insurers determine the cost efficiency of health care and have incentives for risk selection. We derive the optimal cost reimbursement function, which balances the incentives for cost efficiency and risk selection. For health cost data from a Swiss health insurer, we find that an optimal cost reimbursement scheme should reimburse costs only up to a threshold.