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August 19, 2019

Verbeteropties gemeentepolis

Publication (in Dutch only)

Gemeentepolissen zijn een groot goed, maar er zijn verbeteringen mogelijk. Het CPB doet 3 aanbevelingen.

March 15, 2019

Selection and moral hazard effects in healthcare

Publication

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. When assessing the effects of voluntary cost-sharing in healthcare on healthcare expenditures, it is important to disentangle moral hazard from selection: are healthcare expenditures low because people pay (a bigger share of) their healthcare expenditures out-of-pocket? Or are people with higher cost-sharing levels healthier? In this study, we separate selection from moral hazard for the combined mandatory and voluntary deductible in the Netherlands. We use proprietary claims data from Dutch health insurers and exploit with a panel regression discontinuity design that we can observe healthcare expenditures before and after the deductibles kick in for 18 year olds.

November 30, 2018

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

Publication

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.

October 18, 2018

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

Publication

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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July 10, 2018

Analyse actieprogramma ‘Werken in de Zorg’

Publication (in Dutch only)

Het CPB heeft op verzoek van PVV, GroenLinks, SP, PvdA, 50PLUS, DENK, SGP en FVD het actieprogramma ‘Werken in de zorg’ geanalyseerd. Naast de budgettaire effecten komen ook de programma-effecten (het effect op de werkgelegenheid in de zorg) van het actieprogramma aan bod.

March 29, 2018

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

Publication

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

Publication

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

Publication

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.

May 18, 2017

De introductie van dure technologie in de zorg

Publication (in Dutch only)

Nieuwe medische technologie kan veel gezondheidswinst opleveren. Toch is niet altijd even duidelijk of en in welke mate er sprake is van gezondheidswinst.

May 18, 2017

De introductie van dure technologie in de zorg: analysekader en case studies

Publication (in Dutch only)

Adoptie van nieuwe medische technologie kan veel gezondheidswinst opleveren en op die manier bijdragen aan de kwaliteit van zorg. Maar de introductie van nieuwe technologie kan ook de zorgkosten opdrijven en daarmee de betaalbaarheid van zorg in gevaar brengen.