Reclassification Risk Management in the Health Insurance Market of Iran
JOURNAL OF HEALTH MANAGEMENT AND INFORMATICS - JOURNAL OF HEALTH MANAGEMENT AND INFORMATICS
1400/2021
چکیده
Introduction: Reclassification risk in the health insurance market happens when premium prices are determined based on the health level. It is necessary for insurance applicants to manage this risk due to uncertainty about the individual’ ؛ s health status in later periods. Guaranteed renewable insurance fully covers this risk because the health level is not taken into account in calculating the premiums. This study is an attempt to calculate the welfare benefits resulting from the coverage of this risk by providing guaranteed renewable insurance in this market. Methods: The economic welfare model in the form of computable general equilibrium has been used to measure welfare. The model is calibrated by the data of social accounting matrix and national health accounts in 2011. Social accounting matrix is extracted based on the latest input-output table for the economy of Iran presented in this year. Results: The results show that, in general, the more guaranteed renewable insurance expands in the health insurance market, the greater the welfare effects will be ؛ therefore, the elimination of basic insurance from this market and provision of the same insurance for all people in the form of guaranteed renewable insurance (complete elimination of reclassification risk) can increase economic welfare up to 6%. Conclusion: Reclassification risk management by providing guaranteed renewable insurance in the health insurance market of Iran, due to increasing the welfare of the insured, will lead to the provision of a unit insurance plan and equal access to health services for all.

