Community Rating in Health Insurance: Trade-Off between Coverage and Selection

Michiel J. Bijlsma, Jan Boone, Gijsbert Zwart
2015 Social Science Research Network  
We analyze the role of community rating in the optimal design of a risk adjustment scheme in competitive health insurance markets when insurers have better information on their customers' risk profiles than the sponsor of health insurance. The sponsor offers insurers a menu of risk adjustment schemes to elicit this information. The optimal scheme includes a voluntary reinsurance option. Additionally, the scheme should sometimes be complemented by a community rating requirement. The resulting
more » ... fficient coverage of low-cost types lowers the sponsor's cost of separating different insurer types. This allows the sponsor to redistribute more rents from low-cost to high-cost consumers.
doi:10.2139/ssrn.2692533 fatcat:u74ljzmbrfhelhgfe57ltdhqum