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Hybrid risk adjustment for pharmaceutical benefits

Author

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  • Manuel García-Goñi
  • Pere Ibern
  • José María Inoriza

Abstract

This paper analyses the application of hybrid risk adjustment versus either prospective or concurrent risk adjustment formulae in the context of funding pharmaceutical benefits for the population of an integrated healthcare delivery organization in Catalonia during years 2002 and 2003. We apply a mixed formula and find that a hybrid risk adjustment model increases incentives for efficiency in the provision of low risk individuals at health organizations not only as a whole but also at each internal department compared to only prospective models by reducing within-group variation of drug expenditures.

Suggested Citation

  • 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.
    • Handle: RePEc:upf:upfses:1139
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    References listed on IDEAS

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    Cited by:

    1. M. Carreras & M. García-Goñi & P. Ibern & J. Coderch & L. Vall-Llosera & J. Inoriza, 2011. "Estimates of patient costs related with population morbidity: can indirect costs affect the results?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 12(4), pages 289-295, August.
    2. García-Goñi, Manuel & Hernández-Quevedo, Cristina & Nuño-Solinís, Roberto & Paolucci, Francesco, 2012. "Pathways towards chronic care-focused healthcare systems: Evidence from Spain," Health Policy, Elsevier, vol. 108(2), pages 236-245.
    3. Vivas-Consuelo, David & Usó-Talamantes, Ruth & Trillo-Mata, José Luis & Caballer-Tarazona, Maria & Barrachina-Martínez, Isabel & Buigues-Pastor, Laia, 2014. "Predictability of pharmaceutical spending in primary health services using Clinical Risk Groups," Health Policy, Elsevier, vol. 116(2), pages 188-195.
    4. Vivas, David & Guadalajara, Natividad & Barrachina, Isabel & Trillo, José-Luis & Usó, Ruth & de-la-Poza, Elena, 2011. "Explaining primary healthcare pharmacy expenditure using classification of medications for chronic conditions," Health Policy, Elsevier, vol. 103(1), pages 9-15.

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    More about this item

    Keywords

    Drug expenditure; hybrid risk-adjustment; morbidity; clinical risk groups;
    All these keywords.

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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