נוסחת הקפיטציה הישראלית: השלכות ממצאי המחקר

  • View
    57

  • Download
    9

Embed Size (px)

DESCRIPTION

: . ' " . ? . ( risk selection ) - - PowerPoint PPT Presentation

Transcript

THE ROLE OF GOVERNMENTS AND N.H.I.

: ' " ? (risk selection) - - 1995 , 80% , 1995 ? ( ) ( ) " " (, ) 1 , ? 2 : : ?

6

????7 1994 1.170-40.455-140.5015-240.7325-340.8135-441.1745-541.6955-642.7865-743.4875+1 = - 2005 0-11.551-40.965-140.4715-240.4025-340.5735-440.6845-541.0755-641.6965-742.8675-843.5685+4.061= - 2010 * * * * 11.411.871.451.925-10.750.940.800.9915-50.380.410.420.4525-150.430.360.470.4035-250.730.410.770.4645-350.780.570.820.6255-451.140.991.181.0365-551.701.791.741.8475-652.633.142.673.1885-753.404.133.454.18+853.524.233.574.271= = 200 * = 4 " (risk adjusters ) - , , , '

2006 ( ) (HCC-DCG) 3

- -

- : : / - , / " - - 0-11.261.311.052.131.731-50.640.620.561.010.915-150.290.280.230.470.3815-250.370.310.380.510.6325-350.520.340.660.571.0835-450.640.50.680.831.1245-550.980.850.911.431.5155-651.551.361.362.322.3265-752.612.442.254.133.8575-853.413.352.795.724.8185+3.893.753.076.495.35"10.820.941.621.741= (% ) -7 3 6 4 6 4 0-100008.06.37.35.81-500003.73.33.43.15-1500001.61.31.51.215-2500001.82.21.62.025-3500002.14.11.93.735-4500002.94.02.73.745-5500005.05.44.54.955-6500008.88.77.27.665-750000.315.114.112.812.075-85000.50.522.319.017.014.885+000028.122.620.116.2 (% ) -7 3 6 4 6 4 0-10.00.033.427.428.921.942.033.91-50.00.017.315.513.912.720.318.75-150.00.07.86.46.15.19.27.615-250.00.08.410.26.18.19.912.125-350.00.010.317.97.514.511.620.935-450.00.014.619.310.714.916.521.545-550.00.025.926.017.417.928.028.655-650.00.042.440.929.427.345.845.465-750.00.068.662.047.938.476.769.775-850.00.089.675.855.231.0103.486.885+0.00.0105.385.264.217.5128.9104.8 (% )

"1.61.7-7 6 0.00.04 0.00.03 6 3.44.14 2.93.57 6 0.00.04 28.829.83 6 13.912.94 21.519.9 / - " - - 0-11.291.331.072.311.851-50.660.630.571.131.115-150.30.290.240.530.4215-250.380.310.390.550.6825-350.540.340.670.611.1635-450.660.50.690.891.2145-550.990.860.911.511.5955-651.571.371.372.422.4165-752.642.452.264.293.9575-853.443.362.825.844.8985+3.933.773.086.655.43"1.020.830.951.721.811= - - - , ,

- - ,

- . - Chart11.00139101580.810.660.38578661951.18303481490.49820448550.48870171140.28576270230.27280967240.45067992950.52311470970.61108053070.39292371560.39480702380.39434493830.56795311340.79087813370.54473515120.5786070030.54457158140.79712717680.852961760.6608262490.75767237270.69479822461.32024188651.21374721861.01802962691.22979317861.13608898892.2618483641.89961371241.69671604482.31125967821.74638472673.65183887852.89037808752.78618634723.81628211752.72285790724.98204485473.793.696.01591061173.4176561318

Sheet2cap rates adjusted according to year of calculation20033102.2505297384meuhmaccclalleumlaw 1calculatedprof/loss0-51.000.810.660.391.180.701175273414951048670967.458155-150.500.490.290.270.450.3491817682315392460512.7917915-250.520.610.390.390.390.4468392819-163-164000656.37651925-350.570.790.540.580.540.6051254343-188-199226983.16586835-450.800.850.660.760.690.7250275723-94-77426670.085469645-551.321.211.021.231.141.1079541998766834593.443421155-652.261.901.702.311.751.8477452151-314-161068484.44436365-753.652.892.793.822.723.0045837578-874-330055751.61900575+4.983.793.696.023.424.0649340451-2008-634557863.043059-58370335.0409224av cost2831.10005326852896.63443058993577.87113189842994.90554243133272.6651436503n 2003 (nov)meuhmaccclalleumtotal0-5100791184450340221760617015235-15156876301605644430143499124641015-25111397196847595205103613100706225-3514381230299651535398385106054635-45978272411674007818585482562945-55780221809444356627111176573955-65453981108343139734202551223065-7524526653122577133009437764575+166684187023463922835316012total7753171626025373797767347768127960-50.12446211520.18850109690.34993409670.03827796455-150.05424464390.1046679190.1615263920.028742813215-250.05005735130.10572146110.25388773860.03717273125-350.06662416010.1999903640.28939020140.049120708735-450.08170620880.22052337010.35069743880.072100554645-550.11637065160.2538538680.63321683730.10451284255-650.17341587170.36380227481.13699768940.173529379265-750.20516734570.44244166472.07867154190.278303205575+0.22732185830.4444579862.99533991520.3978142856

Sheet2

law 1calculated

Sheet1

200220022003200420052007macclalmeuhleumlaw 1law 20-11.091.261.030.391.261.551-50.740.611.030.391.260.965-150.480.320.510.270.480.4715-250.610.440.540.390.420.425-350.780.610.590.580.580.5735-450.850.740.820.760.740.6845-551.201.141.361.231.211.0755-651.881.92.332.311.861.6965-752.873.123.763.822.92.8675-853.654.043.196.023.643.5685+4.194.433.196.023.644.06macabi2002clal2002otherratesn (nov)std insadj ratesmaccratesn(nov)std insadj ratesclalratesstd ins0-11.093657339993.6835156081.100.810-11.266829786054.221.130.661.2283322.341.120.541-50.74146477107681.3216419770.741-50.61266006162263.660.540.42111722.520.395-150.48291328141201.376517120.490.495-150.32648971207670.720.290.290.24155753.040.220.2215-250.61193228117106.5938099680.610.6115-250.44594989261795.160.390.390.36214196.040.330.3325-350.78308827242235.4353960650.790.7925-350.61496051302591.110.540.540.56277788.560.520.5235-450.85233943197903.0372302770.850.8535-450.74408149302030.260.660.660.74302030.260.680.6845-551.20177178213280.3702466621.211.2145-551.14436118497174.521.021.021.13492813.341.041.0455-651.88103861195672.880783831.901.9055-651.9306191581762.91.701.701.88575639.081.731.7365-752.8761001174865.6288016592.892.8965-753.12257826804417.122.792.793.27843091.023.013.0175-853.6531390114546.193933173.683.7975-854.04176135711585.43.613.694.1722153.53.773.9185+4.19822234435.9906286184.2285+4.4354289240500.273.964.76258415.644.38total0.991774284315920181578922.512504951.001.00total1.119810239237129914157845.341.001.001.08724350264036925.3411.00meuhmeuh20032003leum2004rates(orig)n (nov)std insadj ratesn (nov)std insratesn (nov)std insadj rates0-50.3975,88129273.87447351810.390-52.01100791202589.911.00100791100931.2018733455-150.27142,93038992.68647761280.275-1511568761568760.5015687678156.326862887315-250.39102,17840340.592082410.3915-251.05111397116966.850.5211139758273.40932151725-350.5895,00154968.24388768970.5825-351.14143812163945.680.5714381281678.473149738135-450.7683,77163470.9723297910.7635-451.697827156523.20.809782777980.560320412845-551.2371,53187968.33585571251.2345-552.6578022206758.31.3278022103007.91246854155-652.3143,03099453.50395340272.3155-654.5445398206106.922.2645398102683.39203079565-753.8229,998114480.8309605813.8265-757.3324526179775.583.652452689565.000334309575+6.0223,001138371.9599792836.0275+10166681666804.981666883040.7236384536total667,3216673212.007207942total7753171556222.441775317775317law 1n 2003std popadj rates0-51.26701523883918.981.185-150.481246410598276.80.4515-250.421007062422966.040.3925-350.581060546615116.680.5435-450.74825629610965.460.6945-551.21765739926544.191.1455-651.86512230952747.81.7565-752.93776451095170.52.7275+3.643160121150283.683.42total1.065057413568127697255990.131cap rates adjusted according to year of calculation2003 meuhmaccclalleumlaw 10-51.000.810.660.391.185-150.500.490.290.270.4515-250.520.610.390.390.3925-350.570.790.540.580.5435-450.800.850.660.760.6945-551.321.211.021.231.1455-652.261.901.702.311.7565-753.652.892.793.822.7275+4.983.793.696.023.42cost per age group 2003 only capitation(total alut sal=21135 )meuhmaccclalleumlaw 1 0-5283523462361115538725-15141014161022817147515-251481177014061182129125-351608229119491733178235-452257247123642269227445-553738351636423683371855-656404550260716922571565-75103398372996911429891175+1410510978132021801711185av cost28312897357829953273=w.a of av costsav cost calc25613075av cost std35733354336834963360profit/loss per age group 2003 only capitationmeuhmaccclalleumtotal0-5104,483,846281,360,567513,829,603206,603,1491,106,277,165% gap of capitation rates5-1510,111,87417,895,519291,606,10494,405,882414,019,380meuhmaccclalleumlaw 115-25-21,213,459-94,391,674-68,610,16411,205,662-173,009,6350-50.730.610.610.30125-3525,061,879-154,129,338-85,956,6234,853,048-210,171,0355-150.960.960.690.55135-451,672,366-47,480,108-36,274,379402,204-81,679,91715-251.151.371.090.92145-55-1,536,88136,597,16432,962,1962,483,51170,505,99025-350.901.291.090.97155-65-31,242,29523,590,567-111,554,272-50,710,391-169,916,39135-450.991.091.041.00165-75-35,016,23835,179,230-272,560,757-75,788,799-348,186,56445-551.010.950.980.99175+-48,667,6168,650,325-473,384,272-156,014,199-669,415,76155-651.120.961.061.211total3,653,476107,272,252-209,942,56437,440,068-61,576,76865-751.160.941.121.28175+1.260.981.181.611av def566-5656-9% of cost02-22-0n 2003 (nov)meuhmaccclalleumtotal0-5100791184450340221760617015235-15156876301605644430143499124641015-25111397196847595205103613100706225-3514381230299651535398385106054635-45978272411674007818585482562945-55780221809444356627111176573955-65453981108343139734202551223065-7524526653122577133009437764575+166684187023463922835316012total775317162602537379776734776812796weighted meanprofits/lossmeuhmaccclalleumreg ratemeuhmaccclalleumtotal0-5283523462361115522950-5-54,460,026-9,510,613-22,686,98186,657,62005-1514101416102281711435-15-41,997,548-82,288,46177,546,11746,739,892015-251481177014061182146215-25-2,075,854-60,574,06633,643,91729,006,003025-351608229119491733198025-3553,561,460-94,083,86916,172,16124,350,248035-452257247123642269237335-4511,350,443-23,621,3283,375,0998,895,786045-553738351636423683362645-55-8,720,81419,936,610-7,151,7