#2152. How the COVID-19 pandemic can distort risk adjustment of health plan payment

July 2026publication date
Proposal available till 28-05-2025
4 total number of authors per manuscript6510 $

The title of the journal is available only for the authors who have already paid for
Journal’s subject area:
Economics, Econometrics and Finance (miscellaneous);
Health Policy;
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Abstract:
We investige how the COVID-19 pandemic changed the healthcare utilization and spending practice and what these changes mean for health plan insuring members. The paper offers a conceptual framework for analyzing the visible and potential implications of the pandemic for the calibration of payment weights and the calculation of payments to insurers.
According to our results, distortions from the pandemic can lead to under- and overpayments, the size of which depends on the features of the risk adjustment system and the distribution of risk types across insurers. The extent to which insurers are disproportionately affected by the pandemic also matters.
Keywords:
COVID-19; Health insurance; Risk adjustment

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