Risk-adjusted capitation. The Israeli experience.
As in a number of countries during the 1990s, Israel's health system has been undergoing structural reform based on public contracting and regulated markets. The main element of the reform was the enactment of the National Health Insurance Law (NHI), which went into effect on 1 January 1995. According to the Law, the sick funds receive risk-adjusted capitation payments, which place them fully at risk for the cost of supplying a legally mandated basket of health benefits. The paper analyses the effects of the NHI on the Israeli competitive health insurance market and discusses the major policy issues facing the Israeli system.
Shmueli
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Department of Health Management, Hebrew University School of Public Health, POB 12272, Jerusalem 91120, Israel. ashmueli@md2.huji.ac.il
Chinitz
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D002204:Capitation Fee / Q000331:legislation & jurisprudence*; D003361:Cost Allocation / Q000379:methods; D004465:Economic Competition; D018166:Health Care Reform / Q000331:legislation & jurisprudence; D006801:Humans; D015273:Insurance Selection Bias; D007348:Insurance, Health / Q000331:legislation & jurisprudence*; D007557:Israel; D009313:National Health Programs / Q000191:economics / Q000331:legislation & jurisprudence*; D020379:Risk Adjustment / Q000331:legislation & jurisprudence*