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Financial incentives in the German Statutory Health Insurance: New findings, new questions

Author

Listed:
  • Stock, Stephanie
  • Schmidt, Harald
  • Büscher, Guido
  • Gerber, Andreas
  • Drabik, Anna
  • Graf, Christian
  • Lüngen, Markus
  • Stollenwerk, Björn

Abstract

Objectives This paper presents findings of a mandatory three-year evaluation of a prevention bonus scheme offered in the German Statutory Health Insurance (SHI). Its objective is to describe the rationale behind the programs, analyze their financial impact and discuss their implications on potentially conflicting goals on solidarity and competition.Methods The analysis included 70,429 insured enrolled in a prevention bonus program in a cohort study. The intervention group and their matched controls were followed for a three-year period. Matching was performed as nearest neighbor matching. The economic analysis comprised all costs relevant for Sickness Funds (SF) in the SHI and was carried out from a SHI perspective. Differences in cost trends between the intervention and the control group were examined applying the paired t-test.Results Regarding mean costs there was a significant difference between the two groups of [euro]177.48 (90% CI [[euro]149.73; [euro]205.24]) in favor of the intervention group. If program costs were considered cost reductions of [euro]100.88 (90% CI [[euro]73.12; [euro]128.63]) were obtained.Conclusions The uptake of a prevention bonus program led to cost reductions in the intervention group compared to the control group even when program costs were considered. However, the results must be interpreted with caution as in addition to financial aspects, socio-economic and health-status, selection bias and the function and use of bonus programs as marketing tools, as well as their long-term sustainability should be considered in future assessments.

Suggested Citation

  • Stock, Stephanie & Schmidt, Harald & Büscher, Guido & Gerber, Andreas & Drabik, Anna & Graf, Christian & Lüngen, Markus & Stollenwerk, Björn, 2010. "Financial incentives in the German Statutory Health Insurance: New findings, new questions," Health Policy, Elsevier, vol. 96(1), pages 51-56, June.
    • Handle: RePEc:eee:hepoli:v:96:y:2010:i:1:p:51-56
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    References listed on IDEAS

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    1. Schmidt, Harald, 2009. "Personal responsibility in the NHS Constitution and the social determinants of health approach: competitive or complementary?," Health Economics, Policy and Law, Cambridge University Press, vol. 4(02), pages 129-138, April.
    2. Markus Wörz & Reinhard Busse, 2005. "Analysing the impact of health‐care system change in the EU member states – Germany," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages 133-149, September.
    3. Stephanie Stock & Björn Stollenwerk & Gabriele Klever-Deichert & Marcus Redaelli & Guido Büscher & Christian Graf & Klaus Möhlendick & Jan Mai & Andreas Gerber & Markus Lüngen & Karl Lauterbach, 2008. "Preliminary analysis of short term financial implications of a prevention bonus program: First results from the German statutory health insurance," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 53(2), pages 78-86, April.
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    1. repec:zbw:rwirep:0373 is not listed on IDEAS
    2. Yanmei Liu & Koustuv Dalal & Björn Stollenwerk, 2013. "The Association between Health System Development and the Burden of Cardiovascular Disease: An Analysis of WHO Country Profiles," PLOS ONE, Public Library of Science, vol. 8(4), pages 1-7, April.
    3. Boris Augurzky & Arndt Reichert & Christoph M. Schmidt, 2012. "The Effect of a Bonus Program for Preventive Health Behavior on Health Expenditures," Ruhr Economic Papers 0373, Rheinisch-Westfälisches Institut für Wirtschaftsforschung, Ruhr-Universität Bochum, Universität Dortmund, Universität Duisburg-Essen.
    4. Paloyo, Alfredo R. & Reichert, Arndt R. & Reuss-Borst, Monika & Tauchmann, Harald, 2015. "Who responds to financial incentives for weight loss? Evidence from a randomized controlled trial," Social Science & Medicine, Elsevier, vol. 145(C), pages 44-52.
    5. Becker, Christian & Holle, Rolf & Stollenwerk, Björn, 2015. "The excess health care costs of KardioPro, an integrated care program for coronary heart disease prevention," Health Policy, Elsevier, vol. 119(6), pages 778-786.
    6. Augurzky, Boris & Reichert, Arndt R. & Schmidt, Christoph M., 2012. "The Effect of a Bonus Program for Preventive Health Behavior on Health Expenditures," Ruhr Economic Papers 373, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    7. Sabine Witt & Reiner Leidl & Christian Becker & Rolf Holle & Michael Block & Johannes Brachmann & Sigmund Silber & Björn Stollenwerk, 2014. "The Effectiveness of the Cardiovascular Disease Prevention Programme ‘KardioPro’ Initiated by a German Sickness Fund: A Time-to-Event Analysis of Routine Data," PLOS ONE, Public Library of Science, vol. 9(12), pages 1-17, December.
    8. Felix G Rebitschek & Gerd Gigerenzer & Ariane Keitel & Sarah Sommer & Christian Groß & Gert G Wagner, 2021. "Acceptance of criteria for health and driver scoring in the general public in Germany," PLOS ONE, Public Library of Science, vol. 16(4), pages 1-14, April.

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