A critical review of the use of R2 in risk equalization research.

IF 3.1 3区 医学 Q1 ECONOMICS European Journal of Health Economics Pub Date : 2024-08-09 DOI:10.1007/s10198-024-01709-8
Wynand P M M van de Ven, Richard C van Kleef
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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.

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对风险均衡研究中 R2 使用情况的批判性审查。
几乎所有估算风险均衡公式系数的实证研究都提出了统计量 R2 值。R2 值通常(隐含地)被解释为风险均衡赔付在多大程度上消除了由监管引起的被保险人的可预测利润和损失,R2 值越高,表明绩效越好。然而,在许多情况下,我们并不知道 R2 = 0.30 的模型是否比 R2 = 0.20 的模型更能减少可预测的利润和损失。在本文中,我们认为在风险均衡的背景下,R2 很难被解释为衡量选择激励的指标,在用作衡量选择激励的指标时,可能会导致错误和误导性的结论,因此对于衡量选择激励并无用处。平均绝对预测误差 (MAPE)、康明预测度量 (CPM) 和支付系统拟合度 (PSF) 等相关统计度量也是如此。在一些例外情况下,R2 可能会有用。我们的建议是,要么对 R2 作出明确、有效和相关的解释,要么不提出 R2。相关的统计量 MAPE、CPM 和 PSF 也是如此。
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来源期刊
CiteScore
6.10
自引率
2.30%
发文量
131
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
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