Evidence map›Paper›PMID 28243775›Full record

ArticleThe European journal of health economics : HEPAC : health economics in prevention and care2017

Switching gains and health plan price elasticities: 20 years of managed competition reforms in The Netherlands.

Rudy Douven, Katalin Katona, Frederik T Schut, Victoria Shestalova

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Article in The European journal of health economics : HEPAC : health economics in prevention and care, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

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5citing papers in PubMed
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3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Adverse selection and consumer inertia: empirical evidence from the Dutch health insurance market.The European journal of health economics : HEPAC : health economics in prevention and care · 2025
    Article
  2. Should administrative costs in health insurance be included in the risk-equalization? An analysis of five countries.The European journal of health economics : HEPAC : health economics in prevention and care · 2022
    Article
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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Rudy DouvenCPB Netherlands Bureau for Economic Policy Analysis, The Hague, The Netherlands. R.Douven@cpb.nl.ORCID http://orcid.org/0000-0003-3948-9678
Katalin KatonaDutch Healthcare Authority, Utrecht, The Netherlands.
Frederik T SchutErasmus University Rotterdam, iBMG, Rotterdam, The Netherlands.
Victoria ShestalovaDutch Healthcare Authority, Utrecht, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

In this paper we estimate health plan price elasticities and financial switching gains for consumers over a 20-year period in which managed competition was introduced in the Dutch health insurance market. The period is characterized by a major health insurance reform in 2006 to provide health insurers with more incentives and tools to compete, and to provide consumers with a more differentiated choice of products. Prior to the reform, in the period 1995-2005, we find a low number of switchers, between 2 and 4% a year, modest average total switching gains of 2 million euros per year and short-term health plan price elasticities ranging from -0.1 to -0.4. The major reform in 2006 resulted in an all-time high switching rate of 18%, total switching gains of 130 million euros, and a high short-term price elasticity of -5.7. During 2007-2015 switching rates returned to lower levels, between 4 and 8% per year, with total switching gains in the order of 40 million euros per year on average. Total switching gains could have been 10 times higher if all consumers had switched to one of the cheapest plans. We find short-term price elasticities ranging between -0.9 and -2.2. Our estimations suggest substantial consumer inertia throughout the entire period, as we find degrees of choice persistence ranging from about 0.8 to 0.9.

Indexed as

Managed CompetitionEconomic CompetitionFees and ChargesInsurance CarriersInsurance, HealthNetherlandsHealth insuranceHealth plan price elasticityManaged competitionSwitching gains

Identifiers

PMID28243775
PMCPMC5602030

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