NATIONAL BUREAU OF ECONOMIC RESEARCH
NATIONAL BUREAU OF ECONOMIC RESEARCH

Julie Shi

Harvard Medical School

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NBER Working Papers and Publications

October 2016Risk Adjustment of Health Plan Payments to Correct Inefficient Plan Choice from Adverse Selection
with Jacob Glazer, Thomas G. McGuire
in Measuring and Modeling Health Care Costs, Ana Aizcorbe, Colin Baker, Ernst Berndt, and David Cutler, editors
This paper develops and implements a statistical methodology to account for the equilibrium effects (aka adverse selection) in design of risk adjustment formula in health insurance markets. Our setting is modeled on the situation in Medicare and the new state Exchanges where individuals sort themselves between a discrete set of plan types (here, two). Our “Silver” and “Gold” plans have fixed characteristics, as in the well-known research on selection and efficiency by Einav and Finkelstein (EF). We build on the EF model in several respects, including by showing that risk adjustment can be used to achieve the premiums that will lead to efficient sorting. The target risk adjustment weights can be found by use of constrained regressions, where the constraints in the estimation are conditi...
March 2014Risk Adjustment of Health Plan Payments to Correct Inefficient Plan Choice from Adverse Selection
with Jacob Glazer, Thomas McGuire: w19998
This paper develops and implements a statistical methodology to account for the equilibrium effects (aka adverse selection) in design of risk adjustment formula in health insurance markets. Our setting is modeled on the situation in Medicare and the new state Exchanges where individuals sort themselves between a discrete set of plan types (here, two). Our "Silver" and "Gold" plans have fixed characteristics, as in the well-known research on selection and efficiency by Einav and Finkelstein (EF). We build on the EF model in several respects, including by showing that risk adjustment can be used to achieve the premiums that will lead to efficient sorting. The target risk adjustment weights can be found by use of constrained regressions, where the constraints in the estimation are conditi...

Forthcoming: Risk Adjustment of Health Plan Payments to Correct Inefficient Plan Choice from Adverse Selection, Jacob Glazer, Thomas G. McGuire, Julie Shi. in Measuring and Modeling Health Care Costs, Aizcorbe, Baker, Berndt, and Cutler. 2017

 
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