IDEAS home Printed from https://ideas.repec.org/a/kap/ijhcfe/v25y2025i3d10.1007_s10754-025-09394-7.html
   My bibliography  Save this article

The impact of periodic updates to health benefits plan: access gains without cost savings?

Author

Listed:
  • Oscar Espinosa

    (Instituto de Evaluación Tecnológica en Salud (IETS)
    Universidad Nacional de Colombia)

  • Paul Rodríguez-Lesmes

    (Instituto de Evaluación Tecnológica en Salud (IETS)
    Universidad del Rosario)

  • Jhonathan Rodríguez

    (Instituto de Evaluación Tecnológica en Salud (IETS)
    Universidad Nacional de Colombia)

  • Diego Ávila

    (Instituto de Evaluación Tecnológica en Salud (IETS)
    Universidad Nacional de Colombia)

  • Sergio Basto

    (Instituto de Evaluación Tecnológica en Salud (IETS))

  • Giancarlo Romano

    (Instituto de Evaluación Tecnológica en Salud (IETS))

  • Lorena Mesa

    (Instituto de Evaluación Tecnológica en Salud (IETS))

  • Hernán Enríquez

    (Instituto de Evaluación Tecnológica en Salud (IETS))

Abstract

Expanding explicit Health Benefit Plans (HBP) is a key strategy for achieving universal health coverage while maintaining financial sustainability. However, little is known about the broader effects of periodic updates to these plans on healthcare utilization, expenditures, and market dynamics. This study examines the impact of including new health technologies in Colombia’s HBP covered by the Capitation Payment Unit (CPU) between 2012 and 2019, using administrative data and a difference-in-differences approach with multiple periods. Our results indicate that inclusion in the HBP-CPU led to a substantial increase in utilization and access, particularly in remote areas, but had mixed effects on expenditures. While the number of unique users and prescription frequency rose significantly, the cost per user remained stable for procedures but increased for medications, likely due to higher demand and market structures. These findings suggest that although periodic HBP updates enhance access and effective coverage, they do not necessarily generate cost savings. Strengthening health technology assessment processes, integrating price regulation policies, and implementing cost-containment mechanisms are essential for ensuring the financial sustainability of health systems that regularly update benefit plans.

Suggested Citation

  • Oscar Espinosa & Paul Rodríguez-Lesmes & Jhonathan Rodríguez & Diego Ávila & Sergio Basto & Giancarlo Romano & Lorena Mesa & Hernán Enríquez, 2025. "The impact of periodic updates to health benefits plan: access gains without cost savings?," International Journal of Health Economics and Management, Springer, vol. 25(3), pages 317-336, September.
    • Handle: RePEc:kap:ijhcfe:v:25:y:2025:i:3:d:10.1007_s10754-025-09394-7
    DOI: 10.1007/s10754-025-09394-7
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s10754-025-09394-7
    File Function: Abstract
    Download Restriction: Access to full text is restricted to subscribers.
    File URL: https://libkey.io/10.1007/s10754-025-09394-7?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to

    for a different version of it.

    More about this item

    Keywords

    ;
    ;
    ;
    ;
    ;
    ;
    ;
    ;

    JEL classification:

    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • C23 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Models with Panel Data; Spatio-temporal Models

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:kap:ijhcfe:v:25:y:2025:i:3:d:10.1007_s10754-025-09394-7. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no bibliographic references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.