Risk-adjusted capitation: recent experiences in The Netherlands.
The market-oriented health care reforms taking place in the Netherlands show a clear resemblance to the proposals for managed competition in U.S. health care. In both countries good risk adjustment mechanisms that prevent cream skimming--that is, that prevent plans from selecting the best health risks--are critical to the success of the reforms. In this paper we present an overview of the Dutch reforms and of our research concerning risk-adjusted capitation payments. Although we are optimistic about the technical possibilities for solving the problem of cream skimming, the implementation of good risk-adjusted capitation is a long-term challenge.
van de Ven
W P
WP
Department of Health Policy and Management, Erasmus University Rotterdam, The Netherlands.
van Vliet
R C
RC
van Barneveld
E M
EM
Lamers
L M
LM
D002204:Capitation Fee / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D003365:Costs and Cost Analysis / Q000379:methods; D018166:Health Care Reform / Q000191:economics*; D007342:Insurance Benefits / Q000191:economics / Q000331:legislation & jurisprudence; D015273:Insurance Selection Bias; D009313:National Health Programs / Q000191:economics; D009426:Netherlands