{"title":"A critical review of the use of R<sup>2</sup> in risk equalization research.","authors":"Wynand P M M van de Ven, Richard C van Kleef","doi":"10.1007/s10198-024-01709-8","DOIUrl":null,"url":null,"abstract":"<p><p>Nearly all empirical studies that estimate the coefficients of a risk equalization formula present the value of the statistical measure R<sup>2</sup>. The R<sup>2</sup>-value is often (implicitly) interpreted as a measure of the extent to which the risk equalization payments remove the regulation-induced predictable profits and losses on the insured, with a higher R<sup>2</sup>-value indicating a better performance. In many cases, however, we do not know whether a model with R<sup>2</sup> = 0.30 reduces the predictable profits and losses more than a model with R<sup>2</sup> = 0.20. In this paper we argue that in the context of risk equalization R<sup>2</sup> is hard to interpret as a measure of selection incentives, can lead to wrong and misleading conclusions when used as a measure of selection incentives, and is therefore not useful for measuring selection incentives. The same is true for related statistical measures such as the Mean Absolute Prediction Error (MAPE), Cumming's Prediction Measure (CPM) and the Payment System Fit (PSF). There are some exceptions where the R<sup>2</sup> can be useful. Our recommendation is to either present the R<sup>2</sup> with a clear, valid, and relevant interpretation or not to present the R<sup>2</sup>. The same holds for the related statistical measures MAPE, CPM and PSF.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":null,"pages":null},"PeriodicalIF":3.1000,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Health Economics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10198-024-01709-8","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ECONOMICS","Score":null,"Total":0}
引用次数: 0
Abstract
Nearly all empirical studies that estimate the coefficients of a risk equalization formula present the value of the statistical measure R2. The R2-value is often (implicitly) interpreted as a measure of the extent to which the risk equalization payments remove the regulation-induced predictable profits and losses on the insured, with a higher R2-value indicating a better performance. In many cases, however, we do not know whether a model with R2 = 0.30 reduces the predictable profits and losses more than a model with R2 = 0.20. In this paper we argue that in the context of risk equalization R2 is hard to interpret as a measure of selection incentives, can lead to wrong and misleading conclusions when used as a measure of selection incentives, and is therefore not useful for measuring selection incentives. The same is true for related statistical measures such as the Mean Absolute Prediction Error (MAPE), Cumming's Prediction Measure (CPM) and the Payment System Fit (PSF). There are some exceptions where the R2 can be useful. Our recommendation is to either present the R2 with a clear, valid, and relevant interpretation or not to present the R2. The same holds for the related statistical measures MAPE, CPM and PSF.
期刊介绍:
The European Journal of Health Economics is a journal of Health Economics and associated disciplines. The growing demand for health economics and the introduction of new guidelines in various European countries were the motivation to generate a highly scientific and at the same time practice oriented journal considering the requirements of various health care systems in Europe. The international scientific board of opinion leaders guarantees high-quality, peer-reviewed publications as well as articles for pragmatic approaches in the field of health economics. We intend to cover all aspects of health economics:
• Basics of health economic approaches and methods
• Pharmacoeconomics
• Health Care Systems
• Pricing and Reimbursement Systems
• Quality-of-Life-Studies The editors reserve the right to reject manuscripts that do not comply with the above-mentioned requirements. The author will be held responsible for false statements or for failure to fulfill the above-mentioned requirements.
Officially cited as: Eur J Health Econ