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按人头付费方案中数据驱动的激励相容

Data-driven incentive alignment in capitation schemes
Journal of Public Economics · 2022 · Mark Braverman、Sylvain Chassang

中文摘要

本文探讨了以广泛的高维记录形式出现的大数据,能否降低政府运营的按人头付费方案(如Medicare Advantage)中私人保险商的逆向选择成本。我们认为,使用数据来提高按人头付费回归的事前精度不太可能有帮助。即使类型变得本质上可观测,协变量的高维性也使得精确估计服务某一给定类型的成本变得不可行:大数据使类型变得可观测,但不一定可解释。这为知情的私人运营方提供了选择服务成本相对较低的类型的空间。相反,我们认为数据可用于形成对私人运营方从选择中获利的无偏且不可操纵的事后估计,从而实现激励相容。

Abstract

This paper explores whether big data, taking the form of extensive high dimensional records, can reduce the cost of adverse selection by private insurers in government-run capitation schemes, such as Medicare Advantage. We argue that using data to improve the ex ante precision of capitation regressions is unlikely to be helpful. Even if types become essentially observable, the high dimensionality of covariates makes it infeasible to precisely estimate the cost of serving a given type: big data makes types observable, but not necessarily interpretable. This gives an informed private operator scope to select types that are relatively cheap to serve. Instead, we argue that data can be used to align incentives by forming unbiased and non-manipulable ex post estimates of a private operator’s gains from selection.
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