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Cost-Sharing Design Matters : A Comparison of the Rebate and Deductible in Healthcare

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Listed:
  • Remmerswaal, Minke

    (Tilburg University, TILEC)

  • Boone, Jan

    (Tilburg University, TILEC)

  • Bijlsma, Michiel

    (Tilburg University, TILEC)

  • Douven, R.C.M.H.

Abstract

Since 2006, the Dutch population has faced two different cost-sharing schemes in health insurance for curative care: a mandatory rebate of 255 euros in 2006 and 2007, and since 2008 a mandatory deductible. Using administrative data for the entire Dutch population, we compare the effect of both cost-sharing schemes on healthcare consumption between 2006 and 2013. We use a regression discontinuity design which exploits the fact that persons younger than eighteen years old neither face a rebate nor a deductible. Our fixed effect estimate shows that for individuals around the age of eighteen, a one euro increase of the deductible reduces healthcare expenditures 18 eurocents more than a euro increase of the rebate. These results demonstrate that differences in the design of a cost-sharing scheme can lead to substantial different effects on total healthcare expenditure.
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Suggested Citation

  • Remmerswaal, Minke & Boone, Jan & Bijlsma, Michiel & Douven, R.C.M.H., 2017. "Cost-Sharing Design Matters : A Comparison of the Rebate and Deductible in Healthcare," Discussion Paper 2017-039, Tilburg University, Tilburg Law and Economic Center.
    • Handle: RePEc:tiu:tiutil:67163c04-3d3b-499c-882c-d68b18c48d82
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    1. Hayen, Arthur P. & Klein, Tobias J. & Salm, Martin, 2021. "Does the framing of patient cost-sharing incentives matter? the effects of deductibles vs. no-claim refunds," Journal of Health Economics, Elsevier, vol. 80(C).

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    Keywords

    deductible; rebate; cost-sharing; healthcare consumption; regression discontinuity; panel data;
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