title: Risk-adjusted capitation: recent experiences in The Netherlands.
abstract: 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.
authors.affiliation: Department of Health Policy and Management, Erasmus University Rotterdam, The Netherlands.
authors.forename: W P
authors.initials: WP
authors.lastname: van de Ven
authors.forename: R C
authors.initials: RC
authors.lastname: van Vliet
authors.forename: E M
authors.initials: EM
authors.lastname: van Barneveld
authors.forename: L M
authors.initials: LM
authors.lastname: Lamers
mesh_terms: 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