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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. 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.

January 18, 2019

De wijkteambenadering nader bekeken

Publication (in Dutch only)

Doel minder dure zorg door inzet wijkteams niet gehaald.

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.

November 22, 2018

Opnieuw invoeren zorgprofielen VV 1-3

Publication (in Dutch only)

De SP heeft het CPB verzocht om de budgettaire effecten te bepalen van het opnieuw invoeren van de zorgprofielen 1 tot en met 3 voor verpleging en verzorging (ZP VV 1-3) in de Wet langdurige zorg (Wlz).

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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September 13, 2018

Are substitute services a barrier to controlling long-term care expenditures?


We show that this reform not only affected consumption of this care type, but also the consumption of three other types of long-term care that are financed through another public scheme.

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.

June 1, 2018

Herberekening budgettaire effecten abonnementstarief in de Wmo

Publication (in Dutch only)

Het ministerie van Volksgezondheid, Welzijn en Sport heeft nieuwe cijfers ontvangen over de Wet maatschappelijke ondersteuning (Wmo). Op verzoek van het ministerie heeft het Centraal Planbureau daarom de budgettaire effecten van het abonnementstarief in de Wmo opnieuw berekend.

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.

February 8, 2018

Competition and pricing behavior in long term care markets: Evidence from the Market for Assistance in Daily Housekeeping Activities


Exploiting a rich data set on the Dutch market for assistance in daily housekeeping activities (ADHA), we find that larger providers obtain a higher price than do small providers. However, compared to other studies on market power in care markets this price difference is considered small to moderate.