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Risk sharing as a supplement to imperfect capitation: a tradeoff between selection and efficiency

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  • van Barneveld, Erik M.
  • Lamers, Leida M.
  • van Vliet, Rene C. J. A.
  • van de Ven, Wynand P. M. M.

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  • van Barneveld, Erik M. & Lamers, Leida M. & van Vliet, Rene C. J. A. & van de Ven, Wynand P. M. M., 2001. "Risk sharing as a supplement to imperfect capitation: a tradeoff between selection and efficiency," Journal of Health Economics, Elsevier, vol. 20(2), pages 147-168, March.
    • Handle: RePEc:eee:jhecon:v:20:y:2001:i:2:p:147-168
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    References listed on IDEAS

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    1. Erik van Barneveld & Leida Lamers & René van Vliet & Wynand van de Ven, 2000. "Ignoring small predictable profits and losses: a new approach for measuring incentives for cream skimming," Health Care Management Science, Springer, vol. 3(2), pages 131-140, February.
    2. van de Ven, Wynand P. M. M. & van Vliet, Rene C. J. A. & Schut, Frederik T. & van Barneveld, Erik M., 2000. "Access to coverage for high-risks in a competitive individual health insurance market: via premium rate restrictions or risk-adjusted premium subsidies?," Journal of Health Economics, Elsevier, vol. 19(3), pages 311-339, May.
    3. Matsaganis, Manos & Glennerster, Howard, 1994. "The threat of 'cream skimming' in the post-reform NHS," Journal of Health Economics, Elsevier, vol. 13(1), pages 31-60, March.
    4. Randall P. Ellis & Thomas G. McGuire, 1993. "Supply-Side and Demand-Side Cost Sharing in Health Care," Journal of Economic Perspectives, American Economic Association, vol. 7(4), pages 135-151, Fall.
    5. van Barneveld, Erik M. & Lamers, Leida M. & van Vliet, René C. J. A. & van de Ven, Wynand P. M. M., 1998. "Mandatory pooling as a supplement to risk-adjusted capitation payments in a competitive health insurance market," Social Science & Medicine, Elsevier, vol. 47(2), pages 223-232, July.
    6. Lamers, Leida M., 1998. "Risk-adjusted capitation payments: Developing a diagnostic cost groups classification for the Dutch situation," Health Policy, Elsevier, vol. 45(1), pages 15-32, July.
    7. Pauly, Mark V., 1984. "Is cream-skimming a problem for the competitive medical market?," Journal of Health Economics, Elsevier, vol. 3(1), pages 87-95, April.
    8. Van de ven, Wynand P.M.M. & Ellis, Randall P., 2000. "Risk adjustment in competitive health plan markets," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 14, pages 755-845, Elsevier.
    9. van de Ven, Wynand P.M.M. & Schut, Frederik T., 1994. "Should catastrophic risks be included in a regulated competitive health insurance market?," Social Science & Medicine, Elsevier, vol. 39(10), pages 1459-1472, November.
    10. Keeler, Emmett B. & Carter, Grace & Newhouse, Joseph P., 1998. "A model of the impact of reimbursement schemes on health plan choice," Journal of Health Economics, Elsevier, vol. 17(3), pages 297-320, June.
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    Cited by:

    1. Stam, Pieter J.A. & van Vliet, René C.J.A. & van de Ven, Wynand P.M.M., 2010. "A limited-sample benchmark approach to assess and improve the performance of risk equalization models," Journal of Health Economics, Elsevier, vol. 29(3), pages 426-437, May.
    2. Mathias Kifmann & Normann Lorenz, 2011. "Optimal cost reimbursement of health insurers to reduce risk selection," Health Economics, John Wiley & Sons, Ltd., vol. 20(5), pages 532-552, May.
    3. Camilo Cid & Randall P. Ellis & Verónica Vargas & Juergen Wasem & Lorena Prieto, 2015. "Global Risk-Adjusted Payment Models," Boston University - Department of Economics - Working Papers Series wp2015-021, Boston University - Department of Economics.
    4. Waitzberg, Ruth & Gerkens, Sophie & Dimova, Antoniya & Bryndová, Lucie & Vrangbæk, Karsten & Jervelund, Signe Smith & Birk, Hans Okkels & Rajan, Selina & Habicht, Triin & Tynkkynen, Liina-Kaisa & Kesk, 2022. "Balancing financial incentives during COVID-19: A comparison of provider payment adjustments across 20 countries," Health Policy, Elsevier, vol. 126(5), pages 398-407.
    5. Layton, Timothy J. & McGuire, Thomas G. & van Kleef, Richard C., 2018. "Deriving risk adjustment payment weights to maximize efficiency of health insurance markets," Journal of Health Economics, Elsevier, vol. 61(C), pages 93-110.
    6. Manuel García-Goñi & Pere Ibern & José María Inoriza, 2009. "Hybrid risk adjustment for pharmaceutical benefits," Working Papers, Research Center on Health and Economics 1139, Department of Economics and Business, Universitat Pompeu Fabra.
    7. Michiel Bijlsma & Jan Boone & Gijsbert Zwart, 2014. "Competition leverage: how the demand side affects optimal risk adjustment," RAND Journal of Economics, RAND Corporation, vol. 45(4), pages 792-815, December.
    8. Richard C. van Kleef & René C. J. A. van Vliet, 2022. "How to deal with persistently low/high spenders in health plan payment systems?," Health Economics, John Wiley & Sons, Ltd., vol. 31(5), pages 784-805, May.
    9. van de Ven, Wynand P. M. M. & Beck, Konstantin & Buchner, Florian & Chernichovsky, Dov & Gardiol, Lucien & Holly, Alberto & Lamers, Leida M. & Schokkaert, Erik & Shmueli, Amir & Spycher, Stephan & Van, 2003. "Risk adjustment and risk selection on the sickness fund insurance market in five European countries," Health Policy, Elsevier, vol. 65(1), pages 75-98, July.
    10. Thomas G. McGuire & Sonja Schillo & Richard C. van Kleef, 2018. "Reinsurance, Repayments, and Risk Adjustment in Individual Health Insurance: Germany, The Netherlands and the U.S. Marketplaces," NBER Working Papers 25374, National Bureau of Economic Research, Inc.
    11. Francesco Paolucci & Amir Shmueli, 2011. "The Introduction of Ex-ante Risk Equalisation in the Australian Private Health Insurance Market: A First Step," Agenda - A Journal of Policy Analysis and Reform, Australian National University, College of Business and Economics, School of Economics, vol. 18(2), pages 71-92.
    12. World Bank, 2009. "Europe and Central Asia - Health insurance and competition," World Bank Publications - Reports 3064, The World Bank Group.
    13. Manuel García-Goñi & Pere Ibern & José Inoriza, 2009. "Hybrid risk adjustment for pharmaceutical benefits," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 10(3), pages 299-308, July.
    14. Greß, Stefan & Okma, Kieke & Hessel, Franz, 2001. "Managed competition in health care in the Netherlands and Germany: Theoretical foundation, empirical findings and policy conclusions," Wirtschaftswissenschaftliche Diskussionspapiere 04/2001, University of Greifswald, Faculty of Law and Economics.
    15. Timothy J. Layton & Thomas G. McGuire, 2017. "Marketplace Plan Payment Options for Dealing with High-Cost Enrollees," American Journal of Health Economics, MIT Press, vol. 3(2), pages 165-191, Spring.
    16. Timothy J. Layton & Randall P. Ellis & Thomas G. McGuire, 2015. "Assessing Incentives for Adverse Selection in Health Plan Payment Systems," Boston University - Department of Economics - Working Papers Series wp2015-024, Boston University - Department of Economics.
    17. Eijkenaar, Frank & van Vliet, René C.J.A., 2017. "Improving risk equalization for individuals with persistently high costs: Experiences from the Netherlands," Health Policy, Elsevier, vol. 121(11), pages 1169-1176.
    18. Karen Eggleston & Anupa Bir, 2009. "Measuring Selection Incentives in Managed Care: Evidence From the Massachusetts State Employee Insurance Program," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 76(1), pages 159-175, March.
    19. Richard C. Kleef & Mieke Reuser, 2021. "How the COVID-19 pandemic can distort risk adjustment of health plan payment," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(7), pages 1005-1016, September.
    20. Eugster, Patrick & Sennhauser, Michèle & Zweifel, Peter, 2010. "Capping risk adjustment?," Journal of Health Economics, Elsevier, vol. 29(4), pages 499-507, July.
    21. Shuli Brammli-Greenberg & Jacob Glazer & Ruth Waitzberg, 2019. "Modest risk-sharing significantly reduces health plans’ incentives for service distortion," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(9), pages 1359-1374, December.

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