Developing and applying risk-adjustment tools

The Foundation's Changes in Health Care Financing and Organization program was designed to support research, demonstration, and evaluation projects examining major changes in health care financing.The purpose of this demonstration project is for developing practical risk assessment tools for large employers and testing risk adjustment approaches in health care purchasing. The objectives of the project are to: (1) test and refine two different practical methods for assessing the relative risk of enrollees in different companies offering a variety of managed health plans; and (2) apply these methods among several employer members of the Bay Area Business Group on Health. By the end of the demonstration, purchasers will use the advanced risk assessment models developed to assess which health plans are most efficient, to negotiate individually and collectively with the plans for better premiums the next year and, for those employers offering multiple plans, to establish their contributions to each plan based on the premium for the most efficient plan.

Grant Details

Amount Awarded $614,326.00

Awarded on: 5/20/1993

Time frame: 6/1/1993 - 3/31/1997

Grant Number: 22538


Pacific Business Group on Health

575 Market Street, Suite 600
San Francisco, 94105-5811


Patricia E. Powers
Project Director