Hybrid risk adjustment for pharmaceutical benefits.
This paper analyses the application of hybrid risk adjustment versus either prospective or concurrent risk adjustment formulae in the context of funding pharmaceutical benefits for the population of an integrated healthcare delivery organisation in Catalonia during years 2002 and 2003. We apply a mixed formula and find that, compared to prospective only models, a hybrid risk adjustment model increases incentives for efficiency in the provision for low risk individuals in health organisations, not only as a whole but also within each internal department, by reducing within-group variation of drug expenditures.
García-Goñi
Manuel
M
Departamento de Economía Aplicada II, Universidad Complutense de Madrid, Campus de Somosaguas, Pozuelo de Alarcón, 28223, Madrid, Spain. mggoni@ccee.ucm.es
Ibern
Pere
P
Inoriza
José María
JM
D000328:Adult; D003365:Costs and Cost Analysis; D019033:Delivery of Health Care, Integrated / Q000191:economics*; D005260:Female; D006304:Health Status; D006801:Humans; D007356:Insurance, Pharmaceutical Services / Q000191:economics*; D008297:Male; D009313:National Health Programs / Q000191:economics; D020379:Risk Adjustment / Q000191:economics*; D018570:Risk Assessment; D013030:Spain