Risk equalization

A.A. Withagen-Koster, R.C. van Kleef & F. Eijkenaar (2024). High-risk pooling for mitigating risk selection incentives in health insurance markets with sophisticated risk equalization: An application based on health survey information. BMC Health Services Research. doi: https://doi.org/10.1186/s12913-024-10774-x
Van Kleef, R., van Vliet, R. & Oskam, M. (2023). Risk Adjustment in Health Insurance Markets Do Not Overlook the “Real” Healthy. Medical Care, special issue on “STATISTICAL METHODS FOR RISK ADJUSTMENT IN HEALTH CARE”. doi: https://doi.org/10.1097/mlr.0000000000001955
Richard C. van Kleef, Mieke Reuser, Thomas G. McGuire, John Armstrong, Konstantin Beck, Shuli Brammli-Greenberg, Randall P. Ellis, Francesco Paolucci, Erik Schokkaert & Juergen Wasem (2024). Scope and Incentives for Risk Selection in Health Insurance Markets with Regulated Competition – A Conceptual Framework and International Comparison, Medical Care Research and Review. doi: https://doi.org/10.1177/10775587231222584
Anja Withagen-Koster, Richard van Kleef & Frank Eijkenaar (2023). Predictable profits and losses in a health insurance market with risk equalization: A multiple-contract period perspective. Health Policy, 131: 104763. doi: https://doi.org/10.1016/j.healthpol.2023.104763
Michel Oskam, Richard van Kleef & Rudy Douven (2023) Heteroscedasticity of residual spending after risk equalization: a potential source of selection incentives in health insurance markets with premium regulation. The European Journal of Health Economics. doi: https://doi.org/10.1007/s10198-023-01592-9
Withagen-Koster, A.A., R.C. van Kleef, F. Eijkenaar (2022) Selection incentives in the Dutch Basic Health Insurance: To what extent does end-of-life spending contribute to predictable profits and losses for selective groups? Medical Care Research and Review. doi: https://doi.org/10.1177%2F10775587221099731
Klein, P.P., R.C. van Kleef. J. Henriquez, F. Paolucci (2022) The interplay between risk adjustment and risk rating in voluntary health insurance. Journal of Risk and Insurance. doi: https://doi.org/10.1111/jori.12394
Van de Ven, W., G. Hamstra, R. van Kleef, M. Reuser, P. Stam (2022). The goal of risk equalization in regulated competitive health insurance markets, European Journal of Health Economics. https://doi.org/10.1007/s10198-022-01457-7
Van Kleef, R. R. van Vliet (2022) How to deal with persistently low/high spenders in health plan payment systems? Health Economics, http://doi.org/10.1002/hec.4477.
Douven, R., L. Kauer, S. Demme, F. Paolucci, W. van de Ven, J. Wasem, X. Zhao (2022). Should administrative costs be included in the risk equalization? An analysis of five countries, European Journal of Health Economics, https://doi.org/10.1007/s10198-022-01436-y
Antonini, M., R.C. van Kleef, J. Henriquez, F. Paolucci (2021), Can risk rating increase the ability of voluntary deductibles to reduce moral hazard? Geneva Papers on Risk and Insurance, https://doi.org/10.1057/s41288-021-00253-3
R. van Kleef, M. Reuser (2021). How the COVID-19 Pandemic Can Distort Risk Adjustment of Health Plan Payment, European Journal of Health Economics. https://doi.org/10.1007/s10198-021-01346-5
McGuire, T.G., S. Schillo, and R.C. van Kleef. Very High and Low Residual Spenders in Private Health Insurance Markets: Germany, The Netherlands and the US Marketplaces, European Journal of Health Economics
R. van Kleef, F. Eijkenaar, R van Vliet & M. Nielen (2020). Exploiting incomplete information in risk adjustment using constrained regression, American Journal of Health Economics, https://doi.org/10.1086/710526
T. McGuire, R. van Kleef, S. van Veen, Paying for Mental Health Care in Private Health Insurance in The Netherlands: Some Lessons for the U.S, Psychiatric Services, accepted February 18, 2020
Withagen-Koster, A.A., van Kleef, R.C. & Eijkenaar, F. (2020) Incorporating self-reported health measures in risk equalization through constrained regression. Eur J Health Econ. https://doi.org/10.1007/s10198-019-01146-y
McGuire T., Schillo S., van Kleef R. (2019) Reinsurance, Repayments, and Risk Adjustment in Individual Health Insurance: Germany, The Netherlands and the US Marketplaces, American Journal of Health Economics
R. van Kleef, T. McGuire, E. Schut, W. van de Ven (2019). Strategies to counteract risk selection in social health insurance markets. Oxford Encyclopedia of Health Economics, Oxford University Press. doi: 10.1093/acrefore/9780190625979.013.62
R. van Kleef, F. Eijkenaar, R. van Vliet (2019), Selection incentives for health insurers in the presence of sophisticated risk adjustment, Medical Care Research and Review
Eijkenaar, F,, R van Kleef, R van Vliet (2018), Risk equalization in competitive health insurance markets: identifying healthy individuals on the basis of multiple-year low spending, Health Services Research
T.J Layton, T.G. McGuire and R.C. van Kleef. (2018). "Deriving risk adjustment payment weights to maximize efficiency of health insurance markets", Journal of Health Economics, https://doi.org/10.1016/j.jhealeco.2018.07.001
A.A. Withagen-Koster, R.C. van Kleef & F. Eijkenaar (2018). Examining unpriced risk heterogeneity in the Dutch health insurance market. The European Journal Of Health Economics. doi: 10.1007/s10198-018-0979-x
F. Eijkenaar, R.C.J.A. van Vliet & R.C. van Kleef (2017). Diagnosis-based Cost Groups in the Dutch Risk-equalization Model: Effects of Clustering Diagnoses and of Allowing Patients to be Classified into Multiple Risk-classes. Medical Care, 56 (1), 91-96. doi: 10.1097/MLR.0000000000000828
F. Eijkenaar & R.C.J.A. van Vliet (2017). Improving risk equalization for individuals with persistently high costs: Experiences from the Netherlands. Health Policy, 121 (11), 1169-1176. doi: 10.1016/j.healthpol.2017.09.007
W.P.M.M. van de Ven, R.C.J.A. van Vliet & R.C. van Kleef (2017). How can the regulator show evidence of (no) risk selection in health insurance markets? Conceptual framework and empirical evidence. European Journal of Health Economics (HEPAC), 18 (2), 167-180. doi: 10.1007/s10198-016-0764-7
F. Eijkenaar & R.C.J.A. van Vliet (2017). Improving risk equalization using information on physiotherapy diagnoses. The European Journal Of Health Economics, 19 (2), 203-211. doi: http://dx.doi.org/10.1007/s10198-017-0874-x
T.J. Layton, R.P. Ellis, T.G. McGuire & R.C. van Kleef (2017). Measuring efficiency of health plan payment systems in managed competition health insurance markets. Journal of Health Economics, 56, 237-255. doi: https://doi.org/10.1016/j.jhealeco.2017.05.004
R.C. van Kleef, T.G. McGuire, R.C.J.A. van Vliet & W.P.M.M. van de Ven (2017). Improving risk equalization with constrained regression. The European Journal Of Health Economics, 18, 1137-1156. doi: http://dx.doi.org/10.1007/s10198-016-0859-1
S.H.C.M. van Veen, R.C. van Kleef, R.C.J.A. van Vliet & W.P.M.M. van de Ven (2017). Exploring the Predictive Power of Interaction Terms in a Sophisticated Risk Equalization Model using Regression Trees. Health Economics. doi: 10.1002/hec.3523
R.C. van Kleef, R.C.J.A. van Vliet & W.P.M.M. van de Ven (2016). Overpaying morbidity adjusters in risk equalization models. European Journal of Health Economics (HEPAC), 17, 885-895. doi: 10.1007/s10198-015-0729-2
K.P.M. van Winssen, R.C. van Kleef & W.P.M.M. van de Ven (2016). Potential determinants of deductible uptake in health insurance: How to increase uptake in The Netherlands? The European Journal Of Health Economics, 17 (9), 1059-1072. doi: http://dx.doi.org/10.1007/s10198-015-0745-2
R.C. van Kleef, R.C.J.A. van Vliet & W.P.M.M. van de Ven (2015). Risicoselectie tegengaan met behoud van doelmatigheid. Economisch-Statistische Berichten, 100 (4720), 628-631.
S.H.C.M. van Veen, R.C. van Kleef, W.P.M.M. van de Ven & R.C.J.A. van Vliet (2015). Is There One Measure-of-Fit that Fits All? A Taxonomy and Review of Measures-of-Fit for Risk Equalization Models. Medical Care Research and Review, 72 (2), 220-243. doi: 10.1177/1077558715572900
W.P.M.M. van de Ven, R.C. van Kleef & R.C.J.A. van Vliet (2015). Hoe kan de Nederlandse Zorgautoriteit (NZa) risicoselectie op de zorgverzekeringsmarkt aantonen en meten? Tijdschrift voor Gezondheidswetenschappen, 93 (4), 147-156. doi: 10.1007/s12508-015-0058-y
S.H.C.M. van Veen, R.C. van Kleef, W.P.M.M. van de Ven & R.C.J.A. van Vliet (2015). Improving the prediction model used in risk equalization: cost and diagnostic information from multiple prior years. The European Journal Of Health Economics, 16 (2), 201-218. doi: http://dx.doi.org/10.1007/s10198-014-0567-7
R.C. van Kleef, R.C.J.A. van Vliet & E.M. van Rooijen (2014). Diagnoses-based cost groups in the Dutch risk-equalization model: The effects of including outpatient diagnoses. Health Policy, 115(1), 52-59. doi: http://dx.doi.org/10.1016/j.healthpol.2013.07.005
R.C. van Kleef, R.C.J.A. van Vliet & W.P.M.M. van de Ven (2013). Risk equalization in The Netherlands: an empirical evaluation. Expert review of pharmacoeconomics & outcomes research, 13 (6), 829-839. doi: http://dx.doi.org/10.1586/14737167.2013.842127
R.C. van Kleef, W.P.M.M. van de Ven & R.C.J.A. van Vliet (2013). Risk selection in a regulated health insurance market: a review of the concept, possibilities and effects. Expert review of pharmacoeconomics & outcomes research, 13 (6), 743-752. doi: http://dx.doi.org/10.1586/14737167.2013.841546

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