“The $9 Billion Upcharge: How Insurers Kept Extra Cash From Medicare,” The Wall Street Journal, January 5, 2019. Insurers’ estimates of cost of future prescriptions are always wrong, and, surprisingly, favor the insurers. $9 billion worth.
See also https://infogovnuggets.com/2019/01/05/projections-as-information/, which deals with projections as information.
Wouldn’t you think the “system” would have controls to adjust for over-estimates? Is the fact that such controls are not working, over time, indicate a failure of Governance? Or of Compliance? Estimates are information, but need to be weighted. Are they in good faith?
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