Centro de Documentacion de Fundación MAPFRE - Health care reform, efficiency of health insurers, and optimal health insurance markets

MAP20150003966

Health care reform, efficiency of health insurers, and optimal health insurance markets / Charles C. Yang

Sumario: This research examines the efficiency of the U.S. health insurers. It shows that more insurers are less efficient than in the previous sample year; however, the results suggest that the federal health care reform has no significant effect on the overall efficiency of all insurers as a whole, which is very low but does not change much over time. This research explores how to improve the efficiency of the health insurance market by proposing state, regional, and national efficiency-based goal-oriented market models and an efficiency duplicating system, and it discusses important implications to the health care compacts, the health insurance exchanges or marketplaces, and the national multistate programs. It also analyzes further moves for efficiency enhancement with regard to payment methods and the health care delivery system. One interesting finding is that the Medicaid program is very efficient because it provides support to the offering of Medicaid coverage and further expansion, which enhances the health welfare of society with fewer resources inputs from the perspective of efficiency. This research should provide important insights for state and federal governments, policy makers, regulators, the health insurance industry, and consumers

En: North American actuarial journal. - Schaumburg : Society of Actuaries, 1997- = ISSN 1092-0277. - 01/12/2014 Tomo 18 Número 4 - 2014 , p. 478-500

1. Seguro de asistencia sanitaria . 2. Métodos de optimización . 3. Reforma sanitaria . 4. Asistencia sanitaria . 5. Política sanitaria . 6. Gestión sanitaria . 7. Coeficientes de rendimiento . 8. Modelos actuariales . 9. Estudios de investigación . 10. Seguro de salud . 11. Cálculo actuarial . 12. Estados Unidos . I. Title.