Risk-adjusted capitation payments for catastrophic risks based on multi-year prior costs
| Autor: | RenéC.J.A. van Vliet, Erik M. van Barneveld, Wynand P.M.M. van de Ven |
|---|---|
| Přispěvatelé: | Erasmus School of Health Policy & Management |
| Rok vydání: | 1997 |
| Předmět: |
Catastrophic risk
Risk Management Government Economic Competition Actuarial science Capitation National Health Programs Health Policy media_common.quotation_subject Fraud Payment Insurance Selection Bias Competition (economics) Cream skimming Health Care Reform Costs and Cost Analysis Humans Risk pool Business Capitation Fee Catastrophic Illness Single-Payer System Netherlands media_common Risk adjusted |
| Zdroj: | Health Policy, 123-135. Elsevier Ireland Ltd ISSUE=39;STARTPAGE=123;ENDPAGE=135;ISSN=0168-8510;TITLE=Health Policy |
| ISSN: | 0168-8510 |
| Popis: | In many countries regulated competition among health insurance companies has recently been proposed or implemented. A crucial issue is whether or not the benefits package offered by competing insurers should also cover catastrophic risks (like several forms of expensive long-term care) in addition to non-catastrophic risks (like hospital care and physician services). In 1988 the Dutch government proposed compulsory national health insurance based on regulated competition among insurers as well as among providers of care. The competing insurers should offer a benefits package covering both non-catastrophic risks and catastrophic risks. The insurers would be largely financed via risk-adjusted capitation payments. The government intended to use a capitation formula that is, besides some demographic variables, based on multi-year prior costs. This paper presents the results of an explorative empirical analysis of the possible consequences of such a capitation formula for catastrophic risks. The main conclusion is that this formula would be inadequate because it would leave ample room for cream skimming. |
| Databáze: | OpenAIRE |
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