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A Proposed condition-based risk adjustment system for the Colombian health Insurance program

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040  ‎$a‎MAP‎$b‎spa‎$d‎MAP
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100  ‎$0‎MAPA20110016876‎$a‎Duncan, Ian
24512‎$a‎A Proposed condition-based risk adjustment system for the Colombian health Insurance program‎$c‎Ian Duncan, Juan Diego Mejia Becerra and Tamim Ahmed
300  ‎$a‎15 p.
520  ‎$a‎This article explores the development of a condition-based risk adjustment system for healthcare financing in Colombia, where the current age-, sex-, and geographic-based system faces significant challenges. These shortcomings, including inadequate compensation for high-risk members, necessitate workarounds that compromise efficiency. We propose a condition-based system that provides more accurate and equitable compensation, eliminating the need for special payments. This research discusses the existing issues in the current system, details the construction process of the condition-based risk adjustment system, and assesses its accuracy. This study not only offers an alternative to the current compensation system but also contributes to the broader discourse on health insurance reform.
522  ‎$a‎Colombia
650 4‎$0‎MAPA20080591182‎$a‎Gerencia de riesgos
650 4‎$0‎MAPA20080545260‎$a‎Riesgos
650 4‎$0‎MAPA20080627904‎$a‎Ciencias Actuariales y Financieras
650 4‎$0‎MAPA20080545338‎$a‎Seguros
650 4‎$0‎MAPA20080539771‎$a‎Salud
7001 ‎$0‎MAPA20250004603‎$a‎Mejia Becerra, Juan Diego
7001 ‎$0‎MAPA20250004610‎$a‎Ahmed, Tamim
7730 ‎$w‎MAP20077000239‎$g‎29/09/2025 Volume 29 Number 3 - 2025 ‎$x‎1092-0277‎$t‎North American actuarial journal‎$d‎Schaumburg : Society of Actuaries, 1997-
856  ‎$u‎https://www.tandfonline.com/doi/full/10.1080/10920277.2024.2387116