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- W2080202375 abstract "PROLOGUE: Until recently, few have been concerned with the details of insurer insolvency except insurers, insurance commissioners, and their advisers. Now we face an expanding array of entities, many sponsored by health care providers, assuming the functions of insurers and also the financial risk. What happens when they experience financial difficulty? The sponsors of these new entities and the policymakers trying to determine an appropriate role for them need a better understanding of insolvency risk, and quickly. This paper addresses that need. The recent banking solvency crisis suggests that it may not be easy to strike a balance between protecting the public from insolvency risk and other policies— such as fostering competition—that can aggravate it. Akula is well qualified to address this subject. While a practicing attorney he represented many carriers as head of the health care group at Goodwin, Procter & Hoar, one of Boston's largest law firms. He was chair of the Massachusetts Bar Association's Health Law Section and its Committee on Insurance and Reimbursement. He now teaches at Harvard University, where he is a visiting lecturer at the School of Public Health and an adjunct lecturer at the Kennedy School of Government, and at the Massachusetts Institute of Technology, where he is a visiting lecturer at the Sloan School of Management. He received his law degree and a doctorate in sociology from Harvard. ABSTRACT: This paper reviews the framework of regulatory and managerial devices that have evolved in response to the special dangers to the public posed by insolvency of health carriers. These devices include “prudential” measures designed to decrease the likelihood of insolvency, and measures to “protect enrollees” in the event that insolvency occurs nevertheless. It also reviews the current debate over how this framework should be adapted to new forms of risk-bearing entities, especially provider-sponsored networks engaged in direct contracting with purchasers of coverage. Parallels to solvency concerns in the banking industry are explored." @default.
- W2080202375 created "2016-06-24" @default.
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- W2080202375 date "1997-01-01" @default.
- W2080202375 modified "2023-09-26" @default.
- W2080202375 title "Insolvency Risk In Health Carriers: Innovation, Competition, And Public Protection" @default.
- W2080202375 cites W2417304717 @default.
- W2080202375 doi "https://doi.org/10.1377/hlthaff.16.1.9" @default.
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