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June 25, 2020

Evaluatie programma’s Beatrixziekenhuis en Bernhoven

Publication (in Dutch only)

Nieuwe manier van werken ziekenhuizen leidt tot doelmatiger zorg zonder kwaliteitsverlies.

June 25, 2020

Casestudie Beatrixziekenhuis en Bernhoven

Publication (in Dutch only)

Het CPB, IQ healthcare en de Nederlandse Zorgautoriteit (NZa) hebben samen een onderzoek uitgevoerd om na te gaan in hoeverre beide ziekenhuizen in de eerste drie jaar van hun programma’s de doelstelling voor een meer doelmatige zorg hebben bereikt. Dit project is uitgevoerd mede op initiatief van Bernhoven, Zorggroep Rivas en het ministerie van VWS. Dit onderzoek is gestart in 2018 en resulteert in een Policy Brief (CPB/IQ healthcare/NZa, 2020) en twee achtergronddocumenten. Eén meer kwantitatief achtergronddocument door het CPB en de NZa met een analyse van gedeclareerde verrichtingen van de beide ziekenhuizen ten opzichte van een controlegroep. Eén meer kwalitatief document door IQ healthcare (Van Dulmen et al., 2020) met daarin een analyse op ziekenhuisniveau, inclusief de beschikbare (openbare) data over kwaliteitsindicatoren en de jaarrekeningen. Het onderliggende document is het achtergronddocument van het CPB en de NZa.

May 27, 2020

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

Publication

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 mental health service. In 2013, the majority of the contract prices equaled these maximum prices. We study price setting after a major policy change in 2014.

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.