Risk equalization and voluntary deductibles: A complex interaction

Kleef, Richard C. van; Beck, Konstantin; Ven, Wynand P.M.M. van de; Vliet, René C.J.A. van

doi:10.1016/j.jhealeco.2007.06.001

Cited by 23 publications

(24 citation statements)

References 11 publications

(9 reference statements)

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“…Note from Table 6 that estimated moral hazard reductions not only fall far short of gross differences in expected HCE as indicated by estimates (1) but are markedly plan specific. Van Kleef et al [2008] and Van Kleef et al…”

Section: Discussionmentioning

confidence: 94%

“…15 As a remedy, it is beneficial not to entirely net out risk-selection effects for determining allowable premium reductions. Empirical evidence by Van Kleef et al [2008] shows that the current RA schemes of the Netherlands and Switzerland do leave room for risk-selection effects in the premium reductions.…”

Section: Discussionmentioning

confidence: 99%

“…It uses HCE from prior years to proxy unobserved differences between individuals which become predetermined in the year the comparison between plans is performed (Lehmann and Zweifel [2004], Van Kleef et al [2008]). In this paper, a mixture between the IV and the 'health proxy' approach will be applied.…”

Section: Literature Reviewmentioning

confidence: 99%

“…However, panel data allows to develop an indicator of health status from prior HCE (see Van Kleef et al [2008], Lehmann and Zweifel [2004], Wolfe and Godderies [1991]). In particular, Lehmann and Zweifel show that residuals from a random-effects Tobit regression of prior HCE on exogenous variables can serve as a proxy for unobserved health.…”

Section: Developing a Proxy For Unobserved Health Statusmentioning

confidence: 99%

See 3 more Smart Citations

Supply-side and demand-side cost sharing in deregulated social health insurance: Which is more effective?

Trottmann

Zweifel

Beck

2012

Journal of Health Economics

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Microeconomic theory predicts that if patients are fully insured and providers are paid fee-forservice, utilization of medical services exceeds the efficient level ('moral hazard effect'). In Switzerland, both demand-side cost sharing and upply-side cost sharing have been introduced to mitigate this problem. Analyzing a panel dataset of about 150,000 adults, we find both types of cost sharing to be effective in curtailing the use of medical services. However, demand-side cost sharing options are preliminarily chosen by individuals in excellent health, causing 'true' cost savings achieved by supply-side cost sharing to be more important. adults, we find both types of cost sharing to be effective in curtailing the use of medical services. However, demand-side cost sharing options are preliminarily chosen by individuals in excellent health, causing 'true' cost savings achieved by supply-side cost sharing to be more important.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Literature Reviewmentioning

confidence: 99%

Section: Developing a Proxy For Unobserved Health Statusmentioning

confidence: 99%

See 2 more Smart Citations

Supply-side and demand-side cost sharing in deregulated social health insurance: Which is more effective?

Trottmann

Zweifel

Beck

2012

Journal of Health Economics

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“…11 CHF1¼h0.61/US$0.90, on 1 January 2008. 12 For a description of the Swiss scheme we refer to Beck et al (2003) and for a description of the data we refer to Van Kleef et al (2008). 13 Van Kleef et al (2008).…”

Section: An Empirical Examplementioning

confidence: 99%

Risk-Type Concentration and Efficiency Incentives: A Challenge for the Risk Adjustment Formula

Kleef

Beck

Buchner

2010

Geneva Pap Risk Insur Issues Pract

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An important goal of risk-adjusted capitation payments (RACPs) to competitive communityrated health plans-that may differ in coverage and/or the organisation of delivering careis to reduce incentives for risk selection while maintaining incentives for efficiency. In most schemes, RACPs are simply based on the average observed costs in risk groups (in a prior year). We show that under this procedure, incentives for efficiency will not always be maintained: when identical risk types are concentrated in the same health plans-due to selection, specialisation or just coincidence-cost savings can be captured by the RACPs and leak away from these plans.

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Moral hazard and selection for voluntary deductibles

et al. 2020

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This paper investigates whether the voluntary deductible in the Dutch health insurance system reduces moral hazard or acts only as a cost reduction tool for low‐risk individuals. We use a sample of 14,089 observations, comprising 2,939 individuals over seven waves from the Longitudinal Internet Studies for the Social sciences panel for the analysis. We employ bivariate models that jointly model the choice of a deductible and health care utilization and supplement the identification with an instrumental variable strategy. The results show that the voluntary deductible reduces moral hazard, especially in the decision to visit a doctor (extensive margin) compared with the number of visits (intensive margin). In addition, a robustness test shows that selection on moral hazard is not present in this context.

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Risk equalization and voluntary deductibles: A complex interaction

Cited by 23 publications

References 11 publications

Supply-side and demand-side cost sharing in deregulated social health insurance: Which is more effective?

Supply-side and demand-side cost sharing in deregulated social health insurance: Which is more effective?

Risk-Type Concentration and Efficiency Incentives: A Challenge for the Risk Adjustment Formula

Moral hazard and selection for voluntary deductibles

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