To combat adverse selection, governments increasingly base payments to health plans and
providers on enrollees' scores from risk-adjustment formulae. In 2004, Medicare began to …

Health plans participating in the Medicare managed care program, called Medicare
Advantage since 2003, have historically attracted healthier enrollees than has the traditional …

Within Medicare, the Medicare Advantage program has historically attracted better risks—
healthier, lower-cost patients—than has traditional Medicare. The disproportionate …

The health economics literature contains two models of selection, one with endogenous
plan characteristics to attract good risks and one with fixed plan characteristics; neither …

Health plans paid by capitation have an incentive to distort the quality of services they offer
to attract profitable and to deter unprofitable enrollees. We characterize plans' rationing as a …

Risk adjustment is intended to minimize selection of patients or enrollees in health plans.
Current efforts generally are recognized as inadequate, but improvement is difficult. The …

Medicare Advantage payment regulations include risk-adjusted capitated reimbursement,
which was implemented to discourage favorable risk selection and encourage the retention …

Context Medicare Part C, or Medicare Advantage (MA), now almost 30 years old, has
generally been viewed as a policy disappointment. Enrollment has vacillated but has never …

This paper re-examines the relation between the predictability of health care spending and
incentives due to adverse selection. Within an explicit model of health plan decisions about …

Competition in health insurance markets may fail to improve health outcomes if consumers
are not able to identify high-quality plans. We develop and apply a novel instrumental …