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Risk selection and benefits in the Medicare+Choice program.

Feldman R, Dowd B, Wrobel M - Health Care Financ Rev (2003)

Bottom Line: We estimate the relation between enhanced benefits offered by the Medicare+Choice (M+C) plan in 1999 and a measure of risk selection based on inpatient encounter data.However, some benefits such as dental coverage were related to favorable risk selection.If M+C plans competed on the basis of benefits and premiums, as they would if they could give untaxed premium rebates, benefits that attract high risks would be underprovided.

View Article: PubMed Central - PubMed

Affiliation: University of Minnesota, Division of Health Services Research and Policy, Mayo Mail Code 729, 420 Delaware Street, SE, Minneapolis, MN 55455-0392, USA. feldm002@umn.edu

ABSTRACT
We estimate the relation between enhanced benefits offered by the Medicare+Choice (M+C) plan in 1999 and a measure of risk selection based on inpatient encounter data. Higher risks are attracted to plans that offer outpatient drug coverage. The risk score increases by 2.2 percent for drug coverage with an annual limit less than $800 and by 3.6 percent for coverage with a limit more than $800. However, some benefits such as dental coverage were related to favorable risk selection. If M+C plans competed on the basis of benefits and premiums, as they would if they could give untaxed premium rebates, benefits that attract high risks would be underprovided.

Show MeSH
Market for Drug Insurance with Adverse Selection and One Premium
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Related In: Results  -  Collection


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f1-hcfr-25-1-023: Market for Drug Insurance with Adverse Selection and One Premium

Mentions: The relation between M+C plan benefits and risk selection can be illustrated by the example of outpatient prescription drugs, which are not covered by traditional Medicare. M+C plans may add this coverage as an enhanced benefit. Figure 1 shows a graph of the market for M+C drug coverage (measured by percent of the population insured).


Risk selection and benefits in the Medicare+Choice program.

Feldman R, Dowd B, Wrobel M - Health Care Financ Rev (2003)

Market for Drug Insurance with Adverse Selection and One Premium
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4194834&req=5

f1-hcfr-25-1-023: Market for Drug Insurance with Adverse Selection and One Premium
Mentions: The relation between M+C plan benefits and risk selection can be illustrated by the example of outpatient prescription drugs, which are not covered by traditional Medicare. M+C plans may add this coverage as an enhanced benefit. Figure 1 shows a graph of the market for M+C drug coverage (measured by percent of the population insured).

Bottom Line: We estimate the relation between enhanced benefits offered by the Medicare+Choice (M+C) plan in 1999 and a measure of risk selection based on inpatient encounter data.However, some benefits such as dental coverage were related to favorable risk selection.If M+C plans competed on the basis of benefits and premiums, as they would if they could give untaxed premium rebates, benefits that attract high risks would be underprovided.

View Article: PubMed Central - PubMed

Affiliation: University of Minnesota, Division of Health Services Research and Policy, Mayo Mail Code 729, 420 Delaware Street, SE, Minneapolis, MN 55455-0392, USA. feldm002@umn.edu

ABSTRACT
We estimate the relation between enhanced benefits offered by the Medicare+Choice (M+C) plan in 1999 and a measure of risk selection based on inpatient encounter data. Higher risks are attracted to plans that offer outpatient drug coverage. The risk score increases by 2.2 percent for drug coverage with an annual limit less than $800 and by 3.6 percent for coverage with a limit more than $800. However, some benefits such as dental coverage were related to favorable risk selection. If M+C plans competed on the basis of benefits and premiums, as they would if they could give untaxed premium rebates, benefits that attract high risks would be underprovided.

Show MeSH