Publications

November 30, 2018

The effect of reinsuring a deductible on pharmaceutical spending: A Dutch case study on low-income people

The basic health insurance in the Netherlands includes a mandatory deductible of currently 385 euros per adult per year. Several municipalities offer a group contract for low-income people in which the deductible is reinsured, meaning that out-of-pocket spending under the deductible is covered by supplementary insurance. This study examines to what extent such reinsurance leads to higher pharmaceutical spending.

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October 18, 2018

Causes of regional variation in Dutch healthcare expenditures: evidence from movers

We assess the relative importance of demand and supply factors as determinants of regional variation in healthcare expenditures in the Netherlands. Our empirical approach follows individuals who migrate between regions. We use individual data on annual healthcare expenditures for the entire Dutch population between the years 2006 and 2013.

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March 29, 2018

Does managed competition constrain hospitals’ contract prices? Evidence from the Netherlands

In the Dutch health care system health insurers negotiate with hospitals about the pricing of hospital products in a managed competition framework. In this paper, we study these contract prices that became for the first time publicly available in 2016. The data show substantive price variation between hospitals for the same products, and within a hospital for the same product across insurers.

December 7, 2017

Cost-Sharing Design Matters: A Comparison of the Rebate and Deductible in Healthcare

Since 2006, the Dutch population has faced two different cost-sharing schemes in health insurance for curative care: a mandatory rebate of 255 euros in 2006 and 2007, and since 2008 a mandatory deductible. Using administrative data for the entire Dutch population, we compare the effect of both cost-sharing schemes on healthcare consumption between 2006 and 2013.

October 12, 2017

Premium levels and demand response in health insurance: relative thinking and zero-price effects

In health care systems with a competitive health insurance market, governments or other sponsors (e.g. employers) often subsidize premiums to encourage enrolment. These subsidies are typically independent of plan choice leaving the absolute premium differences in place so as not to distort consumer choice of plan.

February 24, 2017

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

In this paper we estimate health plan price elasticities and financial switching gains for consumers over a 20 years period in which managed competition was introduced in the Dutch health insurance market.

March 24, 2016

Does independent needs assessment limit supply-side moral hazard in long-term care?

The decision about the amount and type of care that a patient needs may be entrusted to health care providers or be delegated to an independent assessor.

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December 23, 2015

Do Extrinsically Motivated Mental Health Care Providers Have Better Treatment Outcomes?

This study compares different responses to financial incentives between self-employed providers in Dutch mental health care.

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November 6, 2014

Unintended effects of reimbursement schedules in mental health care

We evaluate the introduction of a reimbursement schedule for self-employed mental health care providers in the Netherlands in 2008.

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