Contract Design: Risk Management and Evaluation

risks and how to evaluate healthcare contracts? The research questions in this series of three articles focus on how reimbursement strategies (especially Pay for Performance P4P), evaluation of measures and methods of risk adjustment can best be integrated in healthcare contracting. This last article of the series will spot light on the specific topic of risk adjustment as well as evaluation and finally controlling of risks as well as other contractual issues. Effective risk adjustment is an aspect that is more and more given weight on the background of competitive health insurance systems and vital healthcare systems [1]. The objective of risk adjustment is to generate and provide information about the risks of morbidity and the risk factors within a specific population group. Based on the obtained risk structure the expected utilisation as well as its costs in future periods shall be predicted. The risk structure of the providers plays a vital role in Pay for Performance (P4P). A prerequisite for optimal incentive-based service models is a (partial) dependence of the agent’s returns on the provider’s gain level. The risk presented by the population base within a population and indicator oriented contracting must be RESEARCH AND THEORY