Risk-adjusted capitation: recent experiences in The Netherlands
The market-oriented health care reforms taking place in the Netherlands show a clear resemblance to the proposals for managed competition in U.S. health care. In both countries good risk adjustment mechanisms that prevent cream skimming--that is, that prevent plans from selecting the best health risks--are critical to the success of the reforms. In this paper we present an overview of the Dutch reforms and of our research concerning risk-adjusted capitation payments. Although we are optimistic about the technical possibilities for solving the problem of cream skimming, the implementation of good risk-adjusted capitation is a long-term challenge.
|Keywords||*Insurance Selection Bias, Capitation Fee/legislation & jurisprudence/*organization & administration, Costs and Cost Analysis/methods, Health Care Reform/*economics, Insurance Benefits/economics/legislation & jurisprudence, National Health Programs/economics, Netherlands|
van de Ven, W.P.M.M., van Barneveld, E.M., Lamers, L.M., & van Vliet, R.C.J.A.. (1994). Risk-adjusted capitation: recent experiences in The Netherlands. Health Affairs: the policy journal of the health sphere. Retrieved from http://hdl.handle.net/1765/8567