Propuesta de mecanismos de pagos ex post para reducir la selección de riesgos en el Sistema de Salud colombiano

Abstract

"This paper describes four forms of risk sharing between insurers and the State, which complement the current capitation payment in the Colombian Health System. These mechanisms reduce the incentives for insurers to select the best risks, at the cost of lower level of efficiency. Through simulations, the paper searches the mechanism that performs best in the tradeoff between selection and efficiency incentives. The empirical analysis suggests that risk sharing for high costs achieves the best performance in the tradeoff. This mechanism fully reimburses a percentage of the most expensive patients for insurers. The methodology is also extended to analyze services not included in the mandatory benefits package. There is evidence that the current method of financing these services does not have a good performance."