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ADDRESSING MARKET SEGMENTATION AND INCENTIVES FOR RISK SELECTION: HOW WELL DOES RISK EQUALISATION IN THE IRISH PRIVATE HEALTH INSURANCE MARKET WORK? ESRI Research Bulletin 2017/05

Keegan, Conor and Teljeur, Conor and Turner, Brian and Thomas, Steve (2017) ADDRESSING MARKET SEGMENTATION AND INCENTIVES FOR RISK SELECTION: HOW WELL DOES RISK EQUALISATION IN THE IRISH PRIVATE HEALTH INSURANCE MARKET WORK? ESRI Research Bulletin 2017/05. UNSPECIFIED.

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    Abstract

    Community rating restricts health insurers from varying premiums based on insurees’ risk profiles. It is a key feature of many health insurance markets. While designed to promote equity, this regulation incentivises insurers to focus on attracting low-risk (profitable) consumers while avoiding high-risk (unprofitable) consumers. This phenomenon is known as “risk selection”. Risk selection has a number of negative consequences, such as market segmentation and poor quality service to high-risk individuals (e.g. the old and sick). It also causes inefficiency where investment focusses on attracting low-risk individuals (e.g. the young and healthy) rather than improving price and quality. The best strategy for reducing risk selection incentives is good risk equalisation. Commonly, this involves providing risk-adjusted premium subsidies to insurers based on insurees’ risk profiles. These subsidies are generally administered through a risk equalisation scheme. Our study investigated the performance of Ireland’s scheme. Despite the liberalisation of the Irish health insurance market in the mid-1990s, bona-fide risk equalisation payments only commenced in 2013. The current risk equalisation system allocates risk-adjusted subsidies to insurers based on the age, sex, level of cover, and hospital utilisation, of insurees.

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    Item Type: Other
    Subjects for non-EU documents: EU policies and themes > Policies & related activities > public health policy (including global activities)
    Countries > Ireland
    Subjects for EU documents: UNSPECIFIED
    EU Series and Periodicals: UNSPECIFIED
    EU Annual Reports: UNSPECIFIED
    Series: Series > Economic and Social Research Institute (ESRI), Dublin > ESRI Research Bulletin
    Depositing User: Phil Wilkin
    Official EU Document: No
    Language: English
    Date Deposited: 04 Jan 2020 17:14
    Number of Pages: 4
    Last Modified: 04 Jan 2020 17:14
    URI: http://aei.pitt.edu/id/eprint/101987

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