New Article: Shmueli, Calculation of the Israeli Risk Adjustment Rates

Shmueli, Amir. “On the Calculation of the Israeli Risk Adjustment Rates.” European Journal of Health Economics 16.3 (2015): 271-277.

 

URL: http://dx.doi.org/10.1007/s10198-014-0572-x

 

Abstract

Objective

The Israeli risk adjustment formula, introduced in 1995 and which serves for the allocation of the health budget to the sickness funds, is unique compared to countries with a similar national health insurance system in that it is not calculated on the basis of actual cost data of the sickness funds but on the basis of quantities retrieved from surveys. The current article aims to analyze the implications of the Israeli methodology.

Methods

The article examines the validity of the Israeli methodology used to set the 2004 risk adjustment rates and compare these rates with the “correct” ones, which are derived from the 2004 internal relative cost scales of the sickness funds.

Results

The Israeli methodology ignores services provided by the sickness funds and assumes constant unit cost across the sickness funds, an assumption which is implausible. Comparing the actual and the “correct” rates, it turns out that the actual rates over-compensate all the sickness funds for members in age 0–14, and under-compensate them for insurees aged 55+. In age 0–4, the over-compensation per capita is about NIS 1,500 while the under-compensation in age group 75+ reaches NIS 1,600.

Conclusions

The current risk adjustment formula distorts the intended competition on good quality care among the sickness funds, and turns it into a competition on profitable members. After 18 years of using incorrect rates, the Israeli risk adjustment rates should be calculated, as is common in other systems, based on individual cost data from the sickness funds.

 

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ToC: Israel Studies 20.2 (2015); Special Section: Bodies In Question

Israel Studies 20.2 (2015) Table of Contents:

 

Special Section: Bodies In Question

Wars of the Wombs: Struggles Over Abortion Policies in Israel (pp. 1-26)

Rebecca Steinfeld

Halutzah or Beauty Queen? National Images of Women in Early Israeli Society (pp. 27-52)

Julie Grimmeisen

‘Re-orient-ation’: Sport and the Transformation of the Jewish Body and Identity (pp. 53-75)

Yotam Hotam

‘Uniting the Nation’s Various Limbs into a National Body’ the Jerusalem People’s House (pp. 76-109)

Esther Grabiner

 

Articles

The Test of Maritime Sovereignty: The Establishment of the Zim National Shipping Company and the Purchase of the Kedmah, 1945–1952 (pp. 110-134)

Kobi Cohen-Hattab

Budgeting for Ultra-Orthodox Education—The Failure of Ultra-Orthodox Politics, 1996–2006 (pp. 135-162)

Hadar Lipshits

The Mizrahi Sociolect in Israel: Origins and Development (pp. 163-182)

Yehudit Henshke

Review Essay: The Theoretical Normalization of Israel in International Relations(pp. 183-189)

[Reviews  of: The Political Psychology of Israeli Prime Ministers: When Hard-Liners Opt for Peace, by Yael S. Aronoff; Why Hawks Become Doves: Shimon Peres and Foreign Policy Change in Israel by Guy Ziv]

Brent E. Sasley

 

Notes on Contributors (pp. 190-191)

Guidelines for Contributors (pp. 192-194)

ToC: Israel Affairs 20.3 (2014)

Israel Affairs, Volume 20, Issue 3, July 2014 is now available online on Taylor & Francis Online.

This new issue contains the following articles:

Articles
The ‘Arab Spring’: implications for US–Israeli relations
Banu Eligür
Pages: 281-301
DOI: 10.1080/13537121.2014.922802

The effects of the ‘Arab Spring’ on Israel’s geostrategic and security environment: the escalating jihadist terror in the Sinai Peninsula
Yehudit Ronen
Pages: 302-317
DOI: 10.1080/13537121.2014.922807

Consolidated monarchies in the post-‘Arab Spring’ era: the case of Jordan
Nur Köprülü
Pages: 318-327
DOI: 10.1080/13537121.2014.922803

Turkish foreign policy after the ‘Arab Spring’: from agenda-setter state to agenda-entrepreneur state
Burak Bilgehan Özpek & Yelda Demirağ
Pages: 328-346
DOI: 10.1080/13537121.2014.922806

Myth and reality, denial and concealment: American Zionist leadership and the Jewish vote in the 1940s
Zohar Segev
Pages: 347-369
DOI: 10.1080/13537121.2014.922808

Middle Eastern intellectual correspondence: Jacob Talmon and Arnold Toynbee revisited
Amikam Nachmani
Pages: 370-398
DOI: 10.1080/13537121.2014.922804

Fiscal allocation to Arab local authorities in Israel, 2004–12
Tal Shahor
Pages: 399-409
DOI: 10.1080/13537121.2014.922809

‘Spring of Youth’ in Beirut: the effects of the Israeli military operation on Lebanon
Dan Naor
Pages: 410-425
DOI: 10.1080/13537121.2014.922805

Book Reviews
Bohaterowie, hochsztaplerzy, opisywacze: wokół Żydowskiego Związku Wojskowego [Heroes, hucksters, storytellers: the Jewish Military Organization
Yehuda Bauer
Pages: 426-429
DOI: 10.1080/13537121.2014.897470

Israel: a history
David Rodman
Pages: 430-431
DOI: 10.1080/13537121.2014.897025

Holy war in Judaism: the fall and rise of a controversial idea
David Rodman
Pages: 431-432
DOI: 10.1080/13537121.2014.897027

Saturday people, Sunday people: Israel through the eyes of a Christian sojourner
David Rodman
Pages: 433-434
DOI: 10.1080/13537121.2014.897028

The Arab Spring, democracy and security: domestic and international ramifications
David Rodman
Pages: 434-436
DOI: 10.1080/13537121.2014.897029

Operation Damocles: Israel’s secret war against Hitler’s scientists, 1951–1967
David Rodman
Pages: 436-437
DOI: 10.1080/13537121.2014.897030

A Jew’s best friend? The image of the dog throughout Jewish history
David Rodman
Pages: 437-438
DOI: 10.1080/13537121.2014.897031

2048
David Rodman
Pages: 438-440
DOI: 10.1080/13537121.2014.897032

Tested by Zion: the Bush administration and the Israeli-Palestinian conflict
David Rodman
Pages: 440-441
DOI: 10.1080/13537121.2014.897033

Routledge handbook of modern Israel
David Rodman
Pages: 441-442
DOI: 10.1080/13537121.2014.897034

Israel’s clandestine diplomacies
David Rodman
Pages: 442-444
DOI: 10.1080/13537121.2014.897026

Erratum
Erratum

Pages: 1-1
DOI: 10.1080/13537121.2014.937589