Hybrid risk adjustment for pharmaceutical benefits
This paper analyses the application of hybrid risk adjustment versus either prospective or concurrent risk adjustment formulae in the context of funding pharmaceutical benefits for the population of an integrated healthcare delivery organization in Catalonia during years 2002 and 2003. We apply a mixed formula and find that a hybrid risk adjustment model increases incentives for efficiency in the provision of low risk individuals at health organizations not only as a whole but also at each internal department compared to only prospective models by reducing within-group variation of drug expenditures.
|Date of creation:||Jan 2009|
|Date of revision:|
|Contact details of provider:|| Web page: http://www.econ.upf.edu/|
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Kathryn Antioch & Randall Ellis & Steve Gillett & Daniel Borovnicar & Ric Marshall, 2007. "Risk adjustment policy options for casemix funding: international lessons in financing reform," The European Journal of Health Economics, Springer, vol. 8(3), pages 195-212, September.
- van Barneveld, Erik M. & Lamers, Leida M. & van Vliet, Rene C. J. A. & van de Ven, Wynand P. M. M., 2001. "Risk sharing as a supplement to imperfect capitation: a tradeoff between selection and efficiency," Journal of Health Economics, Elsevier, vol. 20(2), pages 147-168, March.
- Corinne Behrend & Florian Buchner & Michael Happich & Rolf Holle & Peter Reitmeir & Jürgen Wasem, 2007.
"Risk-adjusted capitation payments: how well do principal inpatient diagnosis-based models work in the German situation? Results from a large data set,"
The European Journal of Health Economics,
Springer, vol. 8(1), pages 31-39, March.
- Behrend, Corinne & Buchner, Florian & Happich, Michael & Holle, Rolf & Reitmeir, Peter & Wasem, Jürgen, 2004. "Risk-Adjusted Capitation Payments: How Well Do Principal Inpatient Diagnosis-Based Models Work in the German Situation? Results From a Large Data Set," IBES Diskussionsbeiträge 134, University of Duisburg-Essen, Institute of Business and Economic Studie (IBES).
- David M. Cutler & Mary Beth Landrum & Kate A. Stewart, 2006.
"Intensive Medical Care and Cardiovascular Disease Disability Reductions,"
NBER Working Papers
12184, National Bureau of Economic Research, Inc.
- David M. Cutler & Mary Beth Landrum & Kate A. Stewart, 2009. "Intensive Medical Care and Cardiovascular Disease Disability Reductions," NBER Chapters, in: Health at Older Ages: The Causes and Consequences of Declining Disability among the Elderly, pages 191-222 National Bureau of Economic Research, Inc.
- Ellis, Randall P. & McGuire, Thomas G., 1988. "Insurance principles and the design of prospective payment systems," Journal of Health Economics, Elsevier, vol. 7(3), pages 215-237, September.
- Joseph P. Newhouse, 1996. "Reimbursing Health Plans and Health Providers: Efficiency in Production versus Selection," Journal of Economic Literature, American Economic Association, vol. 34(3), pages 1236-1263, September.
- 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.
- Manuel Garc�a-Go�i & Pere Ibern, 2008. "Predictability of drug expenditures: an application using morbidity data," Health Economics, John Wiley & Sons, Ltd., vol. 17(1), pages 119-126.
- Nigel Rice & Paul Dixon & David Lloyd & David Roberts, 1999. "Derivation of a needs based capitation formula for allocation prescribing budgets," Working Papers 034cheop, Centre for Health Economics, University of York.
- Keeler, Emmett B. & Carter, Grace M. & Trude, Sally, 1988. "Insurance aspects of DRG outlier payments," Journal of Health Economics, Elsevier, vol. 7(3), pages 193-214, September.
- Schokkaert, Erik & Van de Voorde, Carine, 2003. "Belgium: risk adjustment and financial responsibility in a centralised system," Health Policy, Elsevier, vol. 65(1), pages 5-19, July.
- Buchner, Florian & Wasem, Jurgen, 2003. "Needs for further improvement: risk adjustment in the German health insurance system," Health Policy, Elsevier, vol. 65(1), pages 21-35, July.
When requesting a correction, please mention this item's handle: RePEc:upf:upfses:1139. See general information about how to correct material in RePEc.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: ()
If references are entirely missing, you can add them using this form.