August 26, 2021

When financials get tough, life gets rough? Problematic debts and ill health

In this paper, we investigate whether individuals obtaining problematic debts are more likely to use mental healthcare or social guidance and/or financial help, and whether they have higher mental healthcare costs.

When financials get tough, life gets rough?
May 27, 2020

Prices and market power in mental health care: Evidence from a major policy change in the Netherlands

In the Dutch health care system of managed competition, insurers and mental health providers negotiate on prices for mental health services. Contract prices are capped by a regulator who sets a maximum price for each...

September 10, 2019

Treatment responses of mental health care providers after a demand shock

This paper investigates how two different groups of Dutch mental health care providers responded to an exogenous 20% drop in the number of patients in 2012.

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April 25, 2019

Can your house keep you out of a nursing home?

We examine the impact of the accessibility of an older individual’s house on her use of nursing home care.

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March 15, 2019

Selection and moral hazard effects in healthcare

In the Netherlands, average healthcare expenditures of persons without a voluntary deductible are twice as high as average healthcare expenditures of persons with a voluntary deductible....

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.