ArticleHealth services research2019
Risk equalization in competitive health insurance markets: Identifying healthy individuals on the basis of multiple-year low spending.
Article in Health services research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
3 citing papers in PubMed.
- How to deal with persistently low/high spenders in health plan payment systems?Health economics · 2022Article
- Does the chronically ill population in the Netherlands switch their health insurer as often as the general population? Empirical evidence from a nationwide survey study.BMC health services research · 2020Article
- Risk equalization in competitive health insurance markets: Identifying healthy individuals on the basis of multiple-year low spending.Health services research · 2019Article
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
objectiveTo study the extent to which risk equalization (RE) in competitive health insurance markets can be improved by including an indicator for being healthy. STUDY SETTING/DATA SOURCES: This study is conducted in the context of the Dutch individual health insurance market. Administrative data on spending and risk characteristics (2011-2014) for the entire population (N = 16.6 m) as well as health survey data from a large sample (N = 387 k) are used. STUDY
designThe indicator for being healthy is low spending in three consecutive prior years. "Low spending" is defined in three ways: belonging to the bottom 60%, 70%, or 80% of the annual spending distribution. Versions of the Dutch RE model 2017 with and without the indicator are compared on individual-level payment fit and, using the survey data, group-level payment fit. PRINCIPAL
findingsAll three alternative models outperform the Dutch RE model 2017. However, significant unpriced risk heterogeneity remains. Compared with the 60% threshold, the 80% threshold comes with a larger improvement in fit but identifies a less selective group.
conclusionsThe performance of the RE model can be improved by adding an indicator for being healthy based on multiple-year low spending. However, risk-selection potential remains, warranting high priority to further improvement of RE.
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Registered trials
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