Risk selection in the health care market: a workshop overview.

In a voluntary health insurance market, risk selection poses serious and increasing problems. Responding to this concern, the Robert Wood Johnson Foundation sponsored an invitational meeting for public and private decision makers to understand the incentives for risk selection in the health insurance market and to discuss options for reducing risk selection practices. The meeting, held October 6, 1994, provided a framework for exploring this timely issue and served as a vehicle for understanding how health care reforms, such as insurance market regulation and risk adjustment mechanisms, both can reduce and exacerbate incentives for risk selection. This article sets the context for the three commissioned papers that follow; it summarizes the ideas presented and issues identified for future consideration. Failure to address risk selection will continue to have serious consequences both for access to care for vulnerable populations and for the financial viability of health plans.