Do Insurers Risk-Select Against Each Other? Evidence from Medicaid and Implications for Health Reform∗
نویسندگان
چکیده
Increasingly in U.S. public insurance programs, the state finances competing, capitated health plans rather than using a fee-for-service (FFS) model. We study how highand low-cost infants (blacks and Hispanics, respectively) are affected by the transition from FFS to Medicaid managed care (MMC). We find that black-Hispanic infant health disparities widen—e.g., black mortality increases by 12% while the Hispanic mortality decreases by 22%—and care worsens for blacks. Additionally, black birth rates fall. We present a model of risk-selection in which capitation incentivizes competing plans to offer better care to low-cost clients to retain them in future periods.
منابع مشابه
Do Insurers Risk-Select Against Each Other? Evidence from Medicaid Managed Care∗
Medicaid programs increasingly finance competing, capitated managed care plans rather than administering fee-for-service (FFS) programs. We study how the transition from FFS to managed care affects highand low-cost infants (blacks and Hispanics, respectively). We find that blackHispanic disparities widen—e.g., black mortality and pre-term birth rates increase by 15% and 7%, respectively, while ...
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