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Previous Volume 339:1952-1956 December 24, 1998 Number 26

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

	Full Text PDF Purchase this article Editorial by Kassirer, J. P. Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

Risk adjustment refers to the adjustment of payments to health plans (or to doctors) to reflect more accurately the actual health status or recent medical experience of patients. Risk adjustment has become an issue because payments by governments, employers, and individuals largely do not take into account differences in the health of patients among (or within) health plans. If plans receive the same unadjusted premium for each subscriber, then the plan with healthier members reaps an unearned windfall, whereas plans with sicker populations of patients face unfair losses.

The problem occurs at three distinct levels. First, health plans that receive . . . [Full Text of this Article]

Experience Rating as Risk Adjustment

Risk Adjustment for Physicians

Bargaining for Risk Adjustment

Risk Adjustment for Health Plans

Risk Adjustment in the States

Repeating U.S. Mistakes?

A Second-Best Solution

References

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