Ajuste por riesgo para el cálculo de la UPC en Colombia: ajuste desde las variables de estado de salud para las aseguradoras colombianas

Jimenez, Lancheros; Fernando, Jeisson

doi:10.15332/tg.mae.2020.0664

Cited by 1 publication

(1 citation statement)

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“…In this scenario, the analysis of the CPU's pricing becomes relevant. In this regard, the specialized literature has investigated alternatives for risk adjustment in SGSSS health spending [4,21,43,44]. However, no studies have been found that develop a particular method for calculating the CPU of the risk groups defined by the legislation.…”

Section: Introductionmentioning

confidence: 99%

Statistical actuarial estimation of the Capitation Payment Unit from copula functions and deep learning: historical comparability analysis for the Colombian health system, 2015–2021

et al. 2023

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The Capitation Payment Unit (CPU) financing mechanism constitutes more than 70% of health spending in Colombia, with a budget allocation of close to 60 trillion Colombian pesos for the year 2022 (approximately 15.7 billion US dollars). This article estimates actuarially, using modern techniques, the CPU for the contributory regime of the General System of Social Security in Health in Colombia, and compares it with what is estimated by the Ministry of Health and Social Protection. Using freely available information systems, by means of statistical copulas functions and artificial neural networks, pure risk premiums are calculated between 2015 and 2021. The study concludes that the weights by risk category are systematically different, showing historical pure premiums surpluses in the group of 0–1 years and deficits (for the regions normal and cities) in the groups over 54 years of age.

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Section: Introductionmentioning

confidence: 99%