As the health insurance underwriting cycle turns: What next?

Health Affairs

Volumn 23, Issue 6, 2004, Pages 91-102

  Grossman, Joy M ^a,b   Ginsburg, Paul B ^a,c  

^a CENTER FOR STUDYING HEALTH SYSTEM CHANGE   (United States)

^b UNIVERSITY OF CALIFORNIA   (United States)

^c HSC ^*

Author keywords

[No Author keywords available]

Indexed keywords

COST CONTROL; HEALTH CARE; HEALTH CARE COST; HEALTH CARE PLANNING; HEALTH CARE POLICY; HEALTH INSURANCE; HEALTH SERVICE; HUMAN; REVIEW;

INSURANCE, HEALTH; INTERVIEWS; MANAGED COMPETITION; RISK ADJUSTMENT; UNITED STATES;

EID: 8844239238     PISSN: 02782715     EISSN: None     Source Type: Journal    
DOI: 10.1377/hlthaff.23.6.91     Document Type: Review

References (18)

1. See, for example, B.C. Strunk and P.B. Ginsburg, "Tracking Health Care Costs: Trends Turn Downward in 2003," Health Affairs, 9 June 2004, content.healthaffairs.org/cgi/content/abstract/hlthaff.w4.354 (23 June 2004); and S. Heffler et al., "Health Spending Projections through 2013," Health Affairs, 11 February 2004, content.healthaffairs.org/cgi/content/ abstract/hlthaff.w4.79 (23 June 2003).
2. See, for example, B.C. Strunk and P.B. Ginsburg, "Tracking Health Care Costs: Trends Turn Downward in 2003," Health Affairs, 9 June 2004, content.healthaffairs.org/cgi/content/abstract/hlthaff.w4.354 (23 June 2004); and S. Heffler et al., "Health Spending Projections through 2013," Health Affairs, 11 February 2004, content.healthaffairs.org/cgi/content/ abstract/hlthaff.w4.79 (23 June 2003).
3. For these contrasting views, compare M. Smith and D. Colby, "Anthem/Wellpoint Investor Presentation," November 2003, www.wellpoint.com/pdf/112003WLPATHInvesPresRev-114XPreVersFinal.pdf (23 June 2004), with M. Borsch and K.P. Huynh, Heading toward an Industry Downturn (New York: Goldman Sachs, 2004); and C. Boorady, S. Mong, and S. Soorya, Stage Set for Strong Late-Cycle Performance (New York: Citigroup Smith Barney, 2004).
4. For these contrasting views, compare M. Smith and D. Colby, "Anthem/Wellpoint Investor Presentation," November 2003, www.wellpoint.com/pdf/112003WLPATHInvesPresRev-114XPreVersFinal.pdf (23 June 2004), with M. Borsch and K.P. Huynh, Heading toward an Industry Downturn (New York: Goldman Sachs, 2004); and C. Boorady, S. Mong, and S. Soorya, Stage Set for Strong Late-Cycle Performance (New York: Citigroup Smith Barney, 2004).
5. For these contrasting views, compare M. Smith and D. Colby, "Anthem/Wellpoint Investor Presentation," November 2003, www.wellpoint.com/pdf/112003WLPATHInvesPresRev-114XPreVersFinal.pdf (23 June 2004), with M. Borsch and K.P. Huynh, Heading toward an Industry Downturn (New York: Goldman Sachs, 2004); and C. Boorady, S. Mong, and S. Soorya, Stage Set for Strong Late-Cycle Performance (New York: Citigroup Smith Barney, 2004).
6. See J. Gabel et al., "Tracing the Cycle of Health Insurance," Health Affairs 10, no. 4 (1991): 48-61; J.R. Gabel and G.A. Jensen, "Can a Universal Coverage System Temper the Underwriting Cycle?" Inquiry 29, no. 2 (1992): 249-262; J.P. Cookson, "Underwriting Gain and Loss Cycles," in Group Insurance, ed. W.F. Bluhm (Winsted, Conn.: ACTEX Publications, 2003), 849-862; and R. Kipp, J.P. Cookson, and L.L. Mattie, Health Insurance Underwriting Cycle Effect on Health Plan Premiums and Profitablity (Washington: Milliman USA, 2003).
7. See J. Gabel et al., "Tracing the Cycle of Health Insurance," Health Affairs 10, no. 4 (1991): 48-61; J.R. Gabel and G.A. Jensen, "Can a Universal Coverage System Temper the Underwriting Cycle?" Inquiry 29, no. 2 (1992): 249-262; J.P. Cookson, "Underwriting Gain and Loss Cycles," in Group Insurance, ed. W.F. Bluhm (Winsted, Conn.: ACTEX Publications, 2003), 849-862; and R. Kipp, J.P. Cookson, and L.L. Mattie, Health Insurance Underwriting Cycle Effect on Health Plan Premiums and Profitablity (Washington: Milliman USA, 2003).
8. See J. Gabel et al., "Tracing the Cycle of Health Insurance," Health Affairs 10, no. 4 (1991): 48-61; J.R. Gabel and G.A. Jensen, "Can a Universal Coverage System Temper the Underwriting Cycle?" Inquiry 29, no. 2 (1992): 249-262; J.P. Cookson, "Underwriting Gain and Loss Cycles," in Group Insurance, ed. W.F. Bluhm (Winsted, Conn.: ACTEX Publications, 2003), 849-862; and R. Kipp, J.P. Cookson, and L.L. Mattie, Health Insurance Underwriting Cycle Effect on Health Plan Premiums and Profitablity (Washington: Milliman USA, 2003).
9. See J. Gabel et al., "Tracing the Cycle of Health Insurance," Health Affairs 10, no. 4 (1991): 48-61; J.R. Gabel and G.A. Jensen, "Can a Universal Coverage System Temper the Underwriting Cycle?" Inquiry 29, no. 2 (1992): 249-262; J.P. Cookson, "Underwriting Gain and Loss Cycles," in Group Insurance, ed. W.F. Bluhm (Winsted, Conn.: ACTEX Publications, 2003), 849-862; and R. Kipp, J.P. Cookson, and L.L. Mattie, Health Insurance Underwriting Cycle Effect on Health Plan Premiums and Profitablity (Washington: Milliman USA, 2003).
10. See, for example, K.E. Thorpe, "The Medical Malpractice 'Crisis': Recent Trends and the Impact of State Tort Reforms," Health Affairs, 21 January 2004, content.healthaffairs.org/cgi/content/abstract/hlthaff.w4.20 (23 June 2004); and R. Klein, "The Underwriting Cycle," in Encyclopedia of Actuarial Science, ed. J. Teugels and B. Sundt (Chichester, U.K.: Wiley, forthcoming).
11. See, for example, K.E. Thorpe, "The Medical Malpractice 'Crisis': Recent Trends and the Impact of State Tort Reforms," Health Affairs, 21 January 2004, content.healthaffairs.org/cgi/content/abstract/hlthaff.w4.20 (23 June 2004); and R. Klein, "The Underwriting Cycle," in Encyclopedia of Actuarial Science, ed. J. Teugels and B. Sundt (Chichester, U.K.: Wiley, forthcoming).
12. Consistent financial time-series data on public companies are limited. While the study focuses on underwriting margins, only after-tax margins for 1992-2003 are available for public companies. Comparable data are provided for the Blues.
13. J. Gabel, "Competition among Health Plans," presented at Joint Federal Trade Commission/Department of Justice Hearings on Health Care and Competition Law and Policy, 23 April 2003, www.ftc.gov/ogc/healthcarehearings/ doc/030423jongabel.pdf (18 August 2004).
14. See R.D. Feldman, D.R. Wholey, and J.B. Christianson, "HMO Consolidations: How National Mergers Affect Local Markets," Health Affairs 18, no. 4 (1999): 96-104, for a discussion of national and local plan entry and consolidation from 1994 to 1997.
15. J.M. Grossman, "Health Plan Competition in Local Markets," Health Services Research 35, no. 1, Part 1 (2000): 17-35.
16. Atlantic Information Services, "Blue Cross and Blue Shield: Not-for-Profit Blues' Strong 2003 Financial Results Could Invite Regulatory Scrutiny," March 2004, www.aishealth.com/ManagedCare/BluesNews/ BLUNPResultsBringScrutiny.html (18 August 2004).
17. Borsch and Huynh, Heading toward an Industry Downturn; and Boorady et al., Stage Set for Strong Late-Cycle Performance.
18. Borsch and Huynh, Heading toward an Industry Downturn; and Boorady et al., Stage Set for Strong Late-Cycle Performance.