Flat capitation (uniform prospective payments) makes enrolling healthy enrollees profitable to health plans.
Plans with relatively generous benefits may attract the sick and fail through a premium spiral.
We simulate a model of idealized managed competition to explore the effect on market performance of alternatives to flat capitation such severity-adjusted capitation and reduced supply-side cost-sharing.
In our model flat capitation causes severe market problems.
Severity adjustement and to a lesser extent reduced supply-side cost-sharing improve market performance, but outcomes are efficient only in cases in which people bear the marginal costs of their choice.
Mots-clés Pascal : Concurrence économique, Risque, Modèle, Etats Unis
Mots-clés Pascal anglais : Competition(economy), Risk, Models, United States
Cote : 15897, P79
Code Inist : 002B30A11. Création : 11/09/1998.