Patient-Level Competitive Bidding and Risk Selection in Health Care Entitlement Programs
نویسنده
چکیده
Prospective payment encourages managed care organizations to select low-risk patients. This article models an entitlement program utilizing patient-level competitive bidding to mitigate risk selection. Three mechanisms are tested: uniform payment, pure bidding, and a mix of payment and bidding. Results show selection always occurs under optimal uniform payment, but never under either bidding mechanism. Mixed bidding eliminates risk selection at the lowest cost. Competitive bidding Pareto dominates uniform payment over 83% of simulated parameter sets. Compared to uniform payment, bidding enrolls 14% more beneficiaries at 24% lower cost, showing the potential for bidding to improve entitlement program access and sustainability.
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