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Patient responsiveness to a differential deductible: empirical results from The Netherlands

Health insurers may use financial incentives to encourage their enrollees to choose preferred providers for medical treatment. Empirical evidence whether differences in cost-sharing rates across providers affects patient choice behavior is, especially from Europe, limited. This paper examines the ef...

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Detalles Bibliográficos
Autores principales: van der Geest, Stéphanie A., Varkevisser, Marco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6517340/
https://www.ncbi.nlm.nih.gov/pubmed/30539335
http://dx.doi.org/10.1007/s10198-018-1014-y
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author van der Geest, Stéphanie A.
Varkevisser, Marco
author_facet van der Geest, Stéphanie A.
Varkevisser, Marco
author_sort van der Geest, Stéphanie A.
collection PubMed
description Health insurers may use financial incentives to encourage their enrollees to choose preferred providers for medical treatment. Empirical evidence whether differences in cost-sharing rates across providers affects patient choice behavior is, especially from Europe, limited. This paper examines the effect of a differential deductible to steer patient provider choice in a Dutch regional market for varicose veins treatment. Using individual patients’ choice data and information about their out-of-pocket payments covering the year of the experiment and 1 year before, we estimate a conditional logit model that explicitly controls for pre-existing patient preferences. Our results suggest that in this natural experiment designating preferred providers and waiving the deductible for enrollees using these providers significantly influenced patient choice. The average cross-price elasticity of demand is found to be 0.02, indicating that patient responsiveness to the cost-sharing differential itself was low. Unlike fixed cost-sharing differences, the deductible exemption was conditional on the patient’s other medical expenses occurring in the policy year. The differential deductible did, therefore, not result in a financial benefit for patients with annual costs exceeding their total deductible.
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spelling pubmed-65173402019-05-28 Patient responsiveness to a differential deductible: empirical results from The Netherlands van der Geest, Stéphanie A. Varkevisser, Marco Eur J Health Econ Original Paper Health insurers may use financial incentives to encourage their enrollees to choose preferred providers for medical treatment. Empirical evidence whether differences in cost-sharing rates across providers affects patient choice behavior is, especially from Europe, limited. This paper examines the effect of a differential deductible to steer patient provider choice in a Dutch regional market for varicose veins treatment. Using individual patients’ choice data and information about their out-of-pocket payments covering the year of the experiment and 1 year before, we estimate a conditional logit model that explicitly controls for pre-existing patient preferences. Our results suggest that in this natural experiment designating preferred providers and waiving the deductible for enrollees using these providers significantly influenced patient choice. The average cross-price elasticity of demand is found to be 0.02, indicating that patient responsiveness to the cost-sharing differential itself was low. Unlike fixed cost-sharing differences, the deductible exemption was conditional on the patient’s other medical expenses occurring in the policy year. The differential deductible did, therefore, not result in a financial benefit for patients with annual costs exceeding their total deductible. Springer Berlin Heidelberg 2018-12-11 2019 /pmc/articles/PMC6517340/ /pubmed/30539335 http://dx.doi.org/10.1007/s10198-018-1014-y Text en © The Author(s) 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Paper
van der Geest, Stéphanie A.
Varkevisser, Marco
Patient responsiveness to a differential deductible: empirical results from The Netherlands
title Patient responsiveness to a differential deductible: empirical results from The Netherlands
title_full Patient responsiveness to a differential deductible: empirical results from The Netherlands
title_fullStr Patient responsiveness to a differential deductible: empirical results from The Netherlands
title_full_unstemmed Patient responsiveness to a differential deductible: empirical results from The Netherlands
title_short Patient responsiveness to a differential deductible: empirical results from The Netherlands
title_sort patient responsiveness to a differential deductible: empirical results from the netherlands
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6517340/
https://www.ncbi.nlm.nih.gov/pubmed/30539335
http://dx.doi.org/10.1007/s10198-018-1014-y
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