CHP Seminar: 23rd November 2017 – Risk equalisation in Chile: an empirical evaluation and proposals for reform

12.30-1.30pm, Thurs 23rd November 2017
Seminar Room 410, Level 4, 207 Bouverie Street, Carlton

Presenter – Dr Francesco Paolucci: Associate Professor in Health Economics & Policy at the School of Business & Governance,  Murdoch University in Perth.

In the Chilean healthcare system all insurers are obliged to offer a minimum set of services, which in the private insurance market are subject to community-rating and risk-equalization regulations. In this paper, we evaluate the current risk-equalization mechanism as well as propose new ones that use all services, new adjusters and methods. Results show that the current method performs poorly in terms of statistical power and improving the formula would help to increase its fit. Further, we study predictive performance by calculating predictive rations for some particular groups, as well as simulate allocations between insurers, comparing each proposed model. We provide evidence that an enhanced risk adjustment formula impacts both predictive ratios and allocations. An interesting result arises as we show some insurers have a mismatch between actual expenditure and risk adjusted one that could be attributed to efficiency in disease management.

Presenter biography:

Dr Paolucci is Associate Professor in Health Economics & Policy at the School of Business & Governance and Head of Health Policy at the Sir Walter Murdoch of Public Policy & International Affairs, Murdoch University in Perth.

A scholar and advisor who over the last decade has published extensively in the areas of public policy, economics and management with a particular focus on healthcare nationally and internationally. This has included one single authored book and three edited special issues in peer reviewed journals as well as over 55 academic peer-reviewed articles, book chapters and book reviews in a wide array of academic journals and presses, and in different languages.

Highlights of his career include: over 10 years of engagement in health economics, policy and management in various countries (e.g. Australia, Chile, China, Colombia, Italy, the Netherlands, Qatar, South Africa, UK, USA etc.) through research, fieldwork and working experience; international experience working for both think-tanks and consultancy firms; academic output well recognised nationally and internationally; high success rate in applications for research funding from public and private agencies; innovative research and training activities and in the promotion of research studies nationally and internationally, and overseas; supervision of doctoral and master thesis and both post- and under- graduate teaching; reviewer since 2007 for the world’s leading journals in health economics and policy; and a strong record of international research collaboration. In 2016 he has received a 40under40 Business News award in WA for his entrepreneurial and business leadership.

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