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Hybrid risk adjustment for pharmaceutical benefits

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  • Manuel García-Goñi
  • Pere Ibern
  • José Inoriza

Abstract

This paper analyses the application of hybrid risk adjustment versus either prospective or concurrent risk adjustment formulae in the context of funding pharmaceutical benefits for the population of an integrated healthcare delivery organization in Catalonia during years 2002 and 2003. We apply a mixed formula and find that a hybrid risk adjustment model increases incentives for efficiency in the provision of low risk individuals at health organizations not only as a whole but also at each internal department compared to only prospective models by reducing within-group variation of drug expenditures.
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  • Manuel García-Goñi & Pere Ibern & José Inoriza, 2009. "Hybrid risk adjustment for pharmaceutical benefits," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 10(3), pages 299-308, July.
    • Handle: RePEc:spr:eujhec:v:10:y:2009:i:3:p:299-308
    DOI: 10.1007/s10198-008-0133-2
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    Cited by:

    1. M. Carreras & M. García-Goñi & P. Ibern & J. Coderch & L. Vall-Llosera & J. Inoriza, 2011. "Estimates of patient costs related with population morbidity: can indirect costs affect the results?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 12(4), pages 289-295, August.
    2. Vivas-Consuelo, David & Usó-Talamantes, Ruth & Trillo-Mata, José Luis & Caballer-Tarazona, Maria & Barrachina-Martínez, Isabel & Buigues-Pastor, Laia, 2014. "Predictability of pharmaceutical spending in primary health services using Clinical Risk Groups," Health Policy, Elsevier, vol. 116(2), pages 188-195.
    3. Vivas, David & Guadalajara, Natividad & Barrachina, Isabel & Trillo, José-Luis & Usó, Ruth & de-la-Poza, Elena, 2011. "Explaining primary healthcare pharmacy expenditure using classification of medications for chronic conditions," Health Policy, Elsevier, vol. 103(1), pages 9-15.
    4. García-Goñi, Manuel & Hernández-Quevedo, Cristina & Nuño-Solinís, Roberto & Paolucci, Francesco, 2012. "Pathways towards chronic care-focused healthcare systems: Evidence from Spain," Health Policy, Elsevier, vol. 108(2), pages 236-245.

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    More about this item

    Keywords

    Clinical risk groups; Drug expenditure; Hybrid risk-adjustment; Morbidity; I18;
    All these keywords.

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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