Risk-Adjusting the Doughnut Hole to Improve Efficiency and Equity

Autor: Richard C. van Kleef, Wynand P. M. M. van de Ven, Rene C. J. A. van Vliet
Jazyk: angličtina
Rok vydání: 2011
Předmět:
Zdroj: Inquiry: The Journal of Health Care Organization, Provision, and Financing, Vol 48 (2011)
Druh dokumentu: article
ISSN: 0046-9580
DOI: 10.5034/inquiryjrnl_48.04.05
Popis: An important goal of consumer cost-sharing in health insurance is to increase incentives for cost containment. A relatively new cost-sharing phenomenon is the “doughnut hole”: a gap in coverage starting at a predefined level of medical expenses. An important question is where to locate the starting point to achieve the strongest incentives for cost containment. We argue that the answer depends on an individual's health status. Using data from a Dutch insurer, this paper illustrates that using a risk-adjusted starting point results in both stronger incentives for cost containment and more equity than a uniform starting point.
Databáze: Directory of Open Access Journals