How can we bend the cost curve? Risk-adjusting the doughnut hole to improve efficiency and equity

Richard C. van Kleef*, Wynand P.M.M. van de Ven, René C.J.A. van Vliet

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Scopus)

Abstract

An important goal of consumer cost-sharing in health insurance is to increase incentives for cost containment. A relatively new cost-sharing phenomenon is the "doughnut hole": a gap in coverage starting at a predefined level of medical expenses. An important question is where to locate the starting point to achieve the strongest incentives for cost containment. We argue that the answer depends on an individual's health status. Using data from aDutch insurer, this paper illustrates that using a risk-adjusted starting point results in both stronger incentives for cost containment and more equity than a uniform starting point.

Original languageEnglish
Pages (from-to)313-321
Number of pages9
JournalInquiry (United States)
Volume48
Issue number4
DOIs
Publication statusPublished - Dec 2012

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