Data transformations to improve the performance of health plan payment methods.

ABSTRACT: The conventional method for developing health care plan payment systems uses observed data to study alternative algorithms and set incentives for the health care system. In this paper, we take a different approach and transform the input data rather than the algorithm, so that the data used reflect the desired spending levels rather than the observed spending levels. We present a general economic model that incorporates the previously overlooked two-way relationship between health plan payment and insurer actions. We then demonstrate our systematic approach for data transformations in two Medicare applications: underprovision of care for individuals with chronic illnesses and health care disparities by geographic income levels. Empirically comparing our method to two other common approache

SUBMITTER: Bergquist SL 

PROVIDER: S-EPMC7442111 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature