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Essay / Research Paper Abstract
A 3 page paper that explains what risk-based insurance is. It explains health assessment and how the health plan determines the risk of any individual. Risk adjustment is also discussed. Bibliography lists 2 sources.
Page Count:
3 pages (~225 words per page)
File: ME12_PG699100.doc
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Unformatted sample text from the term paper:
on the risk the insurance company is taking by insuring that person or group. Health risk assessment is an objective way to determine if an individual or group reflects a
risk that is similar to the average in the population. If the risk is not close, the difference is quantified to determine its deviation (American Academy of Actuaries, 2010). Individuals
who would be expected to incur higher health costs are determined to be higher risk than those who will incur lower costs. There are many factors considered in health assessments
and each person is scored based on an algorithm that is comprised of those factors. Issues include the individuals age, present health status, past health status, life style, familys health
status (American Academy of Actuaries, 2010). It is like a multiple choice survey that we each complete when we go to a new doctor or apply for health insurance. The
response to each question results in a score or numerical value (American Academy of Actuaries, 2010). These are combined to generate a weighted average value that is used to
compare the individual to others in the group (American Academy of Actuaries, 2010). The individuals average is compared to the groups average. A risk score example could reflect
the following: male is 32 years old, which has a risk weight of 0.22; he has diabetes with significant co-morbidities for a risk weight of 1.32; he has asthma/COPD which
is a risk weight of 0.96; and he has low cost dermatology issues for a risk weight of 0.30. the total risk weight is 2.80. In this case, the population
average weight score is 1.0. The insurance company would expect this mans health costs to be 2.8 times the average member in the group (American Academy of Actuaries, 2010). Pre-existing
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