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Optionen der Weiterentwicklung des Risikostrukturausgleichs in der GKV

  • Friedrich Breyer
  • Mathias Kifmann

The system of risk equalization payments among German Statutory Sickness Funds is currently under intensive political debate. While some participants claim that the enormous size of the equalization payments are detrimental to effective competition among funds, others argue that there are still funds which engage heavily in risk selection and are thereby able to keep their contribution rates low. In this paper the major options for a modification of the current system are analyzed both theoretically and empirically with respect to their capacity to diminish the spread of contribution rates, while preserving incentives for an efficient delivery of health care services. In particular, we examine the inclusion of additional risk adjusters in the equalization formula and the formation of a high-risk pool. The data suggest that it is indeed possible to improve the formula without diminishing the incentives for efficiency if the risk adjusters "income" and "marital status" are included.

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File URL: http://www.diw.de/documents/publikationen/73/diw_01.c.38592.de/dp236.pdf
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Paper provided by DIW Berlin, German Institute for Economic Research in its series Discussion Papers of DIW Berlin with number 236.

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Length: 63 p.
Date of creation: 2001
Date of revision:
Handle: RePEc:diw:diwwpp:dp236
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  1. Van de ven, Wynand P.M.M. & Ellis, Randall P., 2000. "Risk adjustment in competitive health plan markets," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 14, pages 755-845 Elsevier.
  2. Nigel Rice & Peter Smith, 1999. "Approaches to capitation and risk adjustment in health care: an international survey," Working Papers 038cheop, Centre for Health Economics, University of York.
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