Centro de Documentacion de Fundación MAPFRE - A Proposed condition-based risk adjustment system for the Colombian health Insurance program

Descripción física: 15 p.Notas: Sumario: This 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.Ámbito geográfico: ColombiaRegistros relacionados: En: North American actuarial journal. - Schaumburg : Society of Actuaries, 1997- = ISSN 1092-0277. - 29/09/2025 Volume 29 Number 3 - 2025 Materia / lugar / evento: Gerencia de riesgos Riesgos Ciencias Actuariales y Financieras Seguros Salud Otros autores: Mejia Becerra, Juan Diego
Ahmed, Tamim
Otras clasificaciones: 7

Derechos: In Copyright (InC)

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