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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.
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