Risk adjustment and risk sharing: The Israeli experience

Amir Shmueli, Dov Chernichovsky, Irit Zmora

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

Israel, like several other countries, introduced a national risk adjusted capitation system during the 1990s. However, the Israeli move was drastic, implementing from the beginning a fully prospective risk adjustment scheme based on age, supplemented by a 100% five condition-specific risk sharing. That scheme, together with open enrollment (periodic switching options), was intended to transform an unregulated competitive health insurance market, characterized by adverse selection and preferred risk selection, into managed competition assuring quality of care, efficiency and fairness. This paper presents the Israeli experience during the first 6 years of the reformed system, focusing on issues related to the risk adjustment and risk sharing arrangements.

Original languageEnglish
Pages (from-to)37-48
Number of pages12
JournalHealth Policy
Volume65
Issue number1
DOIs
StatePublished - 1 Jul 2003

Keywords

  • Capitation
  • Israel
  • National health insurance
  • Risk adjustment
  • Risk sharing

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