Does a mandatory telemedicine call prior to visiting a physician reduce costs or simply attract good risks?
AbstractThis paper aims to estimate empirically the efficiency of a Swiss telemedicine service introduced in 2003. We used claims' data gathered by a major Swiss health insurer, over a period of six years and involving 160 000 insured adults. In Switzerland, health insurance is mandatory, but everyone has the option of choosing between a managed care plan and a fee-for-service plan. The present paper focuses on a conventional fee-for-service plan including a mandatory access to a telemedicine service; the insured are obliged to phone this medical call centre prior to visiting a physician. This type of plan generates much lower average health expenditures than a conventional insurance plan. Reasons for this may include selection, incentive effects or simply efficiency. In our sample, about 90% of the difference in health expenditure can be explained by selection and incentive effects. The remaining 10% of savings due to the efficiency of the telemedicine service amount to about SFr 150 per year per insured, of which approx. 60% is saved by the insurer and 40% by the insured. While the plan is cost-effective, the big winners are the insured who not only save monetary and non-monetary costs, but also benefit from reduced premiums.
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Bibliographic InfoPaper provided by University of Lausanne, Institute of Health Economics and Management (IEMS) in its series Working Papers with number 0801.
Length: 21 pages
Date of creation: Mar 2008
Date of revision:
health; insurance; selection; efficiency; telemedicine;
Other versions of this item:
- Chantal Grandchamp & Lucien Gardiol, 2011. "Does a mandatory telemedicine call prior to visiting a physician reduce costs or simply attract good risks?," Health Economics, John Wiley & Sons, Ltd., vol. 20(10), pages 1257-1267, October.
- I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
- D12 - Microeconomics - - Household Behavior - - - Consumer Economics: Empirical Analysis
- C21 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Cross-Sectional Models; Spatial Models; Treatment Effect Models
This paper has been announced in the following NEP Reports:
- NEP-ALL-2008-03-15 (All new papers)
- NEP-HEA-2008-03-15 (Health Economics)
- NEP-IAS-2008-03-15 (Insurance Economics)
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