Risk-adjusted capitation: recent experiences in The Netherlands
January 1994
Article
| Related Files |
|---|
View PDF Version
(7868016.pdf, 0.2MB) |
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
- Netherlands
- Health Care Reform/*economics
- *Insurance Selection Bias
- Capitation Fee/legislation & jurisprudence/*organization & administration
- Costs and Cost Analysis/methods
- Insurance Benefits/economics/legislation & jurisprudence
- National Health Programs/economics
Automatically Extracted Terms
- health
- capitation
- payment
- risk-adjusted capitation payments
- insurer
- risk-adjusted
- percent
- person
- insurance
- adjuster
- cream
- expenditure
- van vliet
- formula
- profit
- group
- reform
- information
- risk adjusters
- system
