adverse selection

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Adverse Selection

Clinical genetics An event in which an insurer avoids underwriting a person whose genetic profile indicates a high chance of suffering an "expensive" condition in the future—e.g., Huntington’s disease (Armed with such information, an insurance carrier may deny coverage—i.e., adversely select—a person with a high risk of suffering the disease in question; alternatively, that person may take out a large insurance policy on standard terms).
Health insurance The tendency of those with greater-than-average health risks to apply for, or maintain, insurance coverage.
Managed Care
(1) A stance adopted by health care insurers, which fiercely compete among themselves to insure the healthiest and wealthiest segment of a particular population, and thus adversely select the population which they target for selling insurance policies.
(2) The selection of a health plan, whether indemnity or managed care, over other plans by those enrollees who are more likely to file claims and use services, causing an inequitable proportion of enrollees requiring more medical services in that plan.

adverse selection

Managed care
1. A stance adopted by health care insurers, which fiercely compete among themselves to insure the healthiest and wealthiest segment of a particular population, and thus adversely select the population which they target for selling insurance policies. See 'Safety net' hospital.
2. A health plan, whether indemnity or managed care, is selected over other plans by enrollees who are more likely to file claims and use services, causing an inequitable proportion of enrollees requiring more medical services in that plan.

adverse selection

The enrollment in a health plan of those who are sicker or use more health care services than the general population.
See also: selection
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References in periodicals archive ?
One challenge for policymaker is that almost any provision that an ordinary consumer or health care provider thinks of as a nice little feature to add to a health finance program, such as a ban on medical underwriting, or a temporary loosening of enrollment rules to cope with consumer confusion problems, can increase anti-selection and cause the spinning plate to fall down.
Studies invariably confirm the severe anti-selection process occurring at the end of each level premium paying period.
We need more research on the practical application of anti-selection mechanisms in the context of child health, and in the use of different anti-selection mechanisms in combination.
insurers largely have avoided an uncomfortable conversation with consumers over the sensitivities involving genetics, namely privacy rights, data security, anti-selection and regulation.
The increase in the young adult coverage rate could backfire, by encouraging anti-selection and driving young adults' claims through the roof.
Dr George Parfitt, of the Birmingham branch of the anti-selection Campaign for State Education, said a fresh crusade would begin in the next two weeks to target this year's batch of eligible voters.
PPACA drafters tried to protect the PPACA exchange system from going down the same anti-selection drain by creating mechanisms both to lock consumers into the exchange system and push consumers toward the exchange system.
Insureds that were at highest risk of a flood would be most likely to want the coverage, and if insurance companies do not have a means of distinguishing higher-risk from lower-risk policies, anti-selection would result.
residents' LTC needs, in part because of the difficulty of dealing with anti-selection concerns.
His commitment to reinstate grammar schools that might be disbanded under controversial parental ballots will be a blow to anti-selection campaigners in Birmingham.
The company's market position is deepened by its loyal and productive career agency distribution channel, which Fitch believes reduces pricing pressure and anti-selection in competitive market environments.
Advisors know that term conversions are anti-selection against the insurance company, since, typically, only policy owners with a health change actually convert their policies.