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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...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2018
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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. |
format | Online Article Text |
id | pubmed-6517340 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT vandergeeststephaniea patientresponsivenesstoadifferentialdeductibleempiricalresultsfromthenetherlands AT varkevissermarco patientresponsivenesstoadifferentialdeductibleempiricalresultsfromthenetherlands |