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The new risk adjustment formula in Germany: Implementation and first experiences

Florian Buchner, Dirk Goepffarth and Juergen Wasem

Health Policy, 2013, vol. 109, issue 3, 253-262

Abstract: In Germany risk adjustment is a core element of the regulatory framework of competition between sickness funds. It shall create a level playing field between funds with very heterogeneous risk structures. Prior to 2009 risk adjustment was mainly by a demographic model. In 2009 morbidity based risk adjustment was introduced, embedded in a broader reform of the statutory health insurance system. The new formula covers 80 “severe” or “costly and chronic” diseases structured in a system of hierarchical groups.

Keywords: Risk adjustment; Health insurance; Competition; Germany; Central health fund (search for similar items in EconPapers)
Date: 2013
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