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Risk adjustment and the fear of markets: The case of Belgium

  • Erik Schokkaert

    ()

  • Carine Van de Voorde

    ()

In Belgium the management and administration of the compulsory and universal health insurance is left to a limited number of non-governmental non-profit sickness funds. Since 1995 these sickness funds are partially financed in a prospective way. The risk adjustment scheme is based on a regression model to explain medical expenditures for different social groups. Medical supply is taken out of the formula to construct risk-adjusted capitation payments. The risk-adjustment formula still leaves scope for risk selection. At the same time, the sickness funds were not given the instruments to exert a real influence on expenditures and the health insurance market has not been opened for new entrants. As a consequence, Belgium runs the danger of ending up in a situation with little incentives for efficiency and considerable profits from cream skimming. Copyright Kluwer Academic Publishers 2000

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File URL: http://hdl.handle.net/10.1023/A:1019089223462
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Article provided by Springer in its journal Health Care Management Science.

Volume (Year): 3 (2000)
Issue (Month): 2 (February)
Pages: 121-130

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Handle: RePEc:kap:hcarem:v:3:y:2000:i:2:p:121-130
Contact details of provider: Web page: http://www.springerlink.com/link.asp?id=101767

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