title: Health-adjusted premium subsidies in the Netherlands.
abstract: The Dutch government has decided to proceed with managed competition in health care. In this paper we report on progress made with health-based risk adjustment, a key issue in managed competition. In 2004 both Diagnostic Cost Groups (DCGs) computed from hospital diagnoses only and Pharmacy-based Cost Groups (PCGs) computed from out-patient prescription drugs are used to set the premium subsidies for competing risk-bearing sickness funds. These health-based risk adjusters appear to be effective and complementary. Risk selection is not a major problem in the Netherlands. Despite the progress made, we are still faced with a full research agenda for risk adjustment in the coming years.
authors.affiliation: Erasmus University Rotterdam, The Netherlands. vandeven@bmg.eur.nl
authors.forename: Wynand P M M
authors.initials: WP
authors.lastname: van de Ven
authors.forename: René C J A
authors.initials: RC
authors.lastname: van Vliet
authors.forename: Leida M
authors.initials: LM
authors.lastname: Lamers
mesh_terms: D005249:Fees and Charges; D006801:Humans; D007348:Insurance, Health / Q000191:economics*; D018854:Managed Competition; D009426:Netherlands; D010593:Pharmaceutical Services / Q000191:economics; D020379:Risk Adjustment