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

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<dc:creator>Duncan, Ian</dc:creator>
<dc:creator>Mejia Becerra, Juan Diego </dc:creator>
<dc:creator>Ahmed, Tamim </dc:creator>
<dc:date>2025-09-29</dc:date>
<dc:description xml:lang="es">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.</dc:description>
<dc:identifier>https://documentacion.fundacionmapfre.org/documentacion/publico/es/bib/188558.do</dc:identifier>
<dc:language>spa</dc:language>
<dc:rights xml:lang="es">InC - http://rightsstatements.org/vocab/InC/1.0/</dc:rights>
<dc:subject xml:lang="es">Gerencia de riesgos</dc:subject>
<dc:subject xml:lang="es">Riesgos</dc:subject>
<dc:subject xml:lang="es">Ciencias Actuariales y Financieras</dc:subject>
<dc:subject xml:lang="es">Seguros</dc:subject>
<dc:subject xml:lang="es">Salud</dc:subject>
<dc:type xml:lang="es">Artículos y capítulos</dc:type>
<dc:title xml:lang="es">A Proposed condition-based risk adjustment system for the Colombian health Insurance program</dc:title>
<dc:format xml:lang="es">15 p.</dc:format>
<dc:relation xml:lang="es">En: North American actuarial journal. - Schaumburg : Society of Actuaries, 1997- = ISSN 1092-0277. - 29/09/2025 Volume 29 Number 3 - 2025 </dc:relation>
<dc:coverage xml:lang="es">Ámbito geográfico: Colombia</dc:coverage>
</rdf:Description>
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