Assessing risk-adjustment approaches under non-random selection.

Harold S Luft; R Adams Dudley

doi:10.5034/inquiryjrnl_41.2.203

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PubMed · 15449434

Assessing risk-adjustment approaches under non-random selection.

Harold S Luft·R Adams Dudley

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Abstract

Various approaches have been proposed to adjust for differences in enrollee risk in health plans. Because risk-selection strategies may have different effects on enrollment, we simulated three types of selection--dumping, skimming, and stinting. Concurrent diagnosis-based risk adjustment, and a hybrid using concurrent adjustment for about 8% of the cases and prospective adjustment for the rest, perform markedly better than prospective or demographic adjustments, both in terms of R2 and the extent to which plans experience unwarranted gains or losses. The simulation approach offers a valuable tool for analysts in assessing various risk-adjustment strategies under different selection situations.

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Female Forecasting Health Expenditures Humans Insurance Pools Male Managed Care Programs Models, Statistical Patient Transfer Probability Random Allocation Risk Adjustment Selection Bias Comparative Study Journal Article Research Support, Non-U.S. Gov't

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Harold S Luft, R Adams Dudley. 2004. Assessing risk-adjustment approaches under non-random selection.. https://doi.org/10.5034/inquiryjrnl_41.2.203

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