IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v76y2013icp150-158.html
   My bibliography  Save this article

A new prevention paradox: The trade-off between reducing incentives for risk selection and increasing the incentives for prevention for health insurers

Author

Listed:
  • Kanters, Tim A.
  • Brouwer, Werner B.F.
  • van Vliet, René C.J.A.
  • van Baal, Pieter H.M.
  • Polder, Johan J.

Abstract

The Dutch risk equalization scheme has been improved over the years by including health related risk adjusters. The purpose of the Dutch risk equalization scheme is to prevent risk selection and to correct for predictable losses and gains for insurers. The objective of this paper is to explore the financial incentives for risk selection under the Dutch risk equalization scheme.

Suggested Citation

  • Kanters, Tim A. & Brouwer, Werner B.F. & van Vliet, René C.J.A. & van Baal, Pieter H.M. & Polder, Johan J., 2013. "A new prevention paradox: The trade-off between reducing incentives for risk selection and increasing the incentives for prevention for health insurers," Social Science & Medicine, Elsevier, vol. 76(C), pages 150-158.
  • Handle: RePEc:eee:socmed:v:76:y:2013:i:c:p:150-158
    DOI: 10.1016/j.socscimed.2012.10.019
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953612007411
    Download Restriction: Full text for ScienceDirect subscribers only

    File URL: https://libkey.io/10.1016/j.socscimed.2012.10.019?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    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. Pieter H. M. van Baal & Talitha L. Feenstra & Rudolf T. Hoogenveen & G. Ardine de Wit & Werner B. F. Brouwer, 2007. "Unrelated medical care in life years gained and the cost utility of primary prevention: in search of a ‘perfect’ cost–utility ratio," Health Economics, John Wiley & Sons, Ltd., vol. 16(4), pages 421-433, April.
    3. van de Ven, Wynand P.M.M. & Beck, Konstantin & Van de Voorde, Carine & Wasem, Jurgen & Zmora, Irit, 2007. "Risk adjustment and risk selection in Europe: 6 years later," Health Policy, Elsevier, vol. 83(2-3), pages 162-179, October.
    4. Office of Health Economics, 2007. "The Economics of Health Care," For School 001490, Office of Health Economics.
    5. Van de Ven, Wynand P. M. M., 2011. "Risk adjustment and risk equalization: what needs to be done?," Health Economics, Policy and Law, Cambridge University Press, vol. 6(01), pages 147-156, January.
    6. Glazer, Jacob & McGuire, Thomas G., 2002. "Setting health plan premiums to ensure efficient quality in health care: minimum variance optimal risk adjustment," Journal of Public Economics, Elsevier, vol. 84(2), pages 153-173, May.
    7. Pieter H. M. van Baal & Talitha L. Feenstra & Johan J. Polder & Rudolf T. Hoogenveen & Werner B. F. Brouwer, 2011. "Economic evaluation and the postponement of health care costs," Health Economics, John Wiley & Sons, Ltd., vol. 20(4), pages 432-445, April.
    8. Hans Maarse & Yvette Bartholomée, 2007. "A public–private analysis of the new Dutch health insurance system," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 8(1), pages 77-82, March.
    9. Heijink, Richard & Noethen, Manuela & Renaud, Thomas & Koopmanschap, Marc & Polder, Johan, 2008. "Cost of illness: An international comparison: Australia, Canada, France, Germany and The Netherlands," Health Policy, Elsevier, vol. 88(1), pages 49-61, October.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Inge Grootjans-van Kampen & Peter M Engelfriet & Pieter H M van Baal, 2014. "Disease Prevention: Saving Lives or Reducing Health Care Costs?," PLOS ONE, Public Library of Science, vol. 9(8), pages 1-5, August.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Albert Wong & Pieter H. M. van Baal & Hendriek C. Boshuizen & Johan J. Polder, 2011. "Exploring the influence of proximity to death on disease‐specific hospital expenditures: a carpaccio of red herrings," Health Economics, John Wiley & Sons, Ltd., vol. 20(4), pages 379-400, April.
    2. Colleen Carey, 2017. "Technological Change and Risk Adjustment: Benefit Design Incentives in Medicare Part D," American Economic Journal: Economic Policy, American Economic Association, vol. 9(1), pages 38-73, February.
    3. 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.
    4. Bergquist, Savannah L. & Layton, Timothy J. & McGuire, Thomas G. & Rose, Sherri, 2019. "Data transformations to improve the performance of health plan payment methods," Journal of Health Economics, Elsevier, vol. 66(C), pages 195-207.
    5. Glazer Jacob & Huskamp Haiden A. & McGuire Thomas G., 2012. "A Prescription for Drug Formulary Evaluation: An Application of Price Indexes," Forum for Health Economics & Policy, De Gruyter, vol. 15(1), pages 1-26, March.
    6. Pilny, Adam & Wübker, Ansgar & Ziebarth, Nicolas R., 2017. "Introducing risk adjustment and free health plan choice in employer-based health insurance: Evidence from Germany," Journal of Health Economics, Elsevier, vol. 56(C), pages 330-351.
    7. Alec Morton & Amanda I. Adler & David Bell & Andrew Briggs & Werner Brouwer & Karl Claxton & Neil Craig & Alastair Fischer & Peter McGregor & Pieter van Baal, 2016. "Unrelated Future Costs and Unrelated Future Benefits: Reflections on NICE Guide to the Methods of Technology Appraisal," Health Economics, John Wiley & Sons, Ltd., vol. 25(8), pages 933-938, August.
    8. Normann Lorenz, 2017. "Using Quantile and Asymmetric Least Squares Regression for Optimal Risk Adjustment," Health Economics, John Wiley & Sons, Ltd., vol. 26(6), pages 724-742, June.
    9. Xu, Weiwei & van de Ven, Wynand P.M.M., 2013. "Consumer choice among Mutual Healthcare Purchasers: A feasible option for China?," Social Science & Medicine, Elsevier, vol. 96(C), pages 277-284.
    10. Göpffarth Dirk, 2007. "Theorie und Praxis des Risikostrukturausgleichs / Risk Adjustment in Theory and Practice," Journal of Economics and Statistics (Jahrbuecher fuer Nationaloekonomie und Statistik), De Gruyter, vol. 227(5-6), pages 485-501, October.
    11. Michelle Tew & Philip Clarke & Karin Thursky & Kim Dalziel, 2019. "Incorporating Future Medical Costs: Impact on Cost-Effectiveness Analysis in Cancer Patients," PharmacoEconomics, Springer, vol. 37(7), pages 931-941, July.
    12. Shmueli, Amir & Stam, Piet & Wasem, Jürgen & Trottmann, Maria, 2015. "Managed care in four managed competition OECD health systems," Health Policy, Elsevier, vol. 119(7), pages 860-873.
    13. Savannah L. Bergquist & Timothy J. Layton & Thomas G. McGuire & Sherri Rose, 2018. "Intervening on the Data to Improve the Performance of Health Plan Payment Methods," NBER Working Papers 24491, National Bureau of Economic Research, Inc.
    14. Glazer, Jacob & McGuire, Thomas G. & Cao, Zhun & Zaslavsky, Alan, 2008. "Using global ratings of health plans to improve the quality of health care," Journal of Health Economics, Elsevier, vol. 27(5), pages 1182-1195, September.
    15. Normann Lorenz, 2014. "Using quantile regression for optimal risk adjustment," Research Papers in Economics 2014-11, University of Trier, Department of Economics.
    16. Mohnen Sigrid M. & Rotteveel Adriënne H. & Doornbos Gerda & Polder Johan J., 2020. "Healthcare Expenditure Prediction with Neighbourhood Variables – A Random Forest Model," Statistics, Politics and Policy, De Gruyter, vol. 11(2), pages 111-138, December.
    17. A. A. Withagen-Koster & R. C. Kleef & F. Eijkenaar, 2020. "Incorporating self-reported health measures in risk equalization through constrained regression," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(4), pages 513-528, June.
    18. Lorenz, Normann, 2015. "The interaction of direct and indirect risk selection," Journal of Health Economics, Elsevier, vol. 42(C), pages 81-89.
    19. Richard van Kleef & Thomas McGuire & Rene van Vliet & Wynand van de Ven, 2015. "Improving Risk Equalization with Constrained Regression," NBER Working Papers 21570, National Bureau of Economic Research, Inc.
    20. Thomson, Sarah & Busse, Reinhard & Crivelli, Luca & van de Ven, Wynand & Van de Voorde, Carine, 2013. "Statutory health insurance competition in Europe: A four-country comparison," Health Policy, Elsevier, vol. 109(3), pages 209-225.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:76:y:2013:i:c:p:150-158. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.