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A structural microsimulation model for demand-side cost-sharing in healthcare

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  • Boone, Jan
  • Remmerswaal, Minke

Abstract

Demand-side cost-sharing schemes reduce moral hazard in healthcare at the expense of out-of-pocket risk. With a structural microsimulation model, we show that shifting the starting point of the deductible away from zero to 400 euros for all insured individuals, leads to an average 4% reduction in healthcare expenditure and 47% lower out-of-pocket payments for people without a chronic condition. We use administrative healthcare expenditure data for the Dutch population to analyze expenditure under different cost-sharing schemes. The model is estimated with a Bayesian mixture model to capture distributions of healthcare expenditure. This allows us to predict the effects of cost-sharing schemes that have not been used in the Netherlands.

Suggested Citation

  • Boone, Jan & Remmerswaal, Minke, 2022. "A structural microsimulation model for demand-side cost-sharing in healthcare," CEPR Discussion Papers 17057, C.E.P.R. Discussion Papers.
    • Handle: RePEc:cpr:ceprdp:17057
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