Publication detail

Improving Risk Adjustment in the Czech Republic

Author(s): Radovan Chalupka Ph.D.,
Type: Articles in journals with impact factor
Year: 2010
Number: 3
ISSN / ISBN: 1210-0455
Published in: Prague Economic Papers
Publishing place: Praha
Keywords: Risk adjustment, Health insurance, Pharmaceutical Cost Groups, Czech Republic
JEL codes: C10, D82, G22, i10, I11, I18
Suggested Citation:
Grants: GACR 402/08/0501 (2008-2010) Political Economy of Public Spending
Abstract: This paper analyses possible options how to improve the risk adjustment of the health insurance system in the Czech Republic. Out of possible options it argues for including Pharmaceutical Cost Groups (PCGs) as additional risk factors since it is an improvement that can be implemented almost instantaneously. On real data from an anonymous sickness fund it confirms that predictive performance of PCGs models is consistently better than the performance of the demographic model that is currently used. The study also describes and examines the Czech health insurance market and implications of proposed changes of policy makers. Based on experience from other countries we point to a problem of risk selection if the changes are not accompanies by a tighter regulation, specifically in the form of improved risk adjustment formula.

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