{"title":"模拟各种费用分摊设计下费用控制激励机制的方法:第一欧元免赔额和甜甜圈洞的应用。","authors":"D Cattel, R C van Kleef, R C J A van Vliet","doi":"10.1007/s10198-016-0843-9","DOIUrl":null,"url":null,"abstract":"<p><p>Many health insurance schemes include deductibles to provide consumers with cost containment incentives (CCI) and to counteract moral hazard. Policymakers are faced with choices on the implementation of a specific cost sharing design. One of the guiding principles in this decision process could be which design leads to the strongest CCI. Despite the vast amount of literature on the effects of cost sharing, the relative effects of specific cost sharing designs-e.g., a traditional deductible versus a doughnut hole-will mostly be absent for a certain context. This papers aims at developing a simulation model to approximate the relative effects of different deductible modalities on the CCI. We argue that the CCI depends on the probability that healthcare expenses end up in the deductible range and the expected healthcare expenses given that they end up in the deductible range. Our empirical application shows that different deductible modalities result in different CCIs and that the CCI under a certain modality differs across risk-groups.</p>","PeriodicalId":51883,"journal":{"name":"Ship Technology Research","volume":"63 1","pages":"987-1000"},"PeriodicalIF":1.4000,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5602006/pdf/","citationCount":"0","resultStr":"{\"title\":\"A method to simulate incentives for cost containment under various cost sharing designs: an application to a first-euro deductible and a doughnut hole.\",\"authors\":\"D Cattel, R C van Kleef, R C J A van Vliet\",\"doi\":\"10.1007/s10198-016-0843-9\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Many health insurance schemes include deductibles to provide consumers with cost containment incentives (CCI) and to counteract moral hazard. Policymakers are faced with choices on the implementation of a specific cost sharing design. One of the guiding principles in this decision process could be which design leads to the strongest CCI. Despite the vast amount of literature on the effects of cost sharing, the relative effects of specific cost sharing designs-e.g., a traditional deductible versus a doughnut hole-will mostly be absent for a certain context. This papers aims at developing a simulation model to approximate the relative effects of different deductible modalities on the CCI. We argue that the CCI depends on the probability that healthcare expenses end up in the deductible range and the expected healthcare expenses given that they end up in the deductible range. Our empirical application shows that different deductible modalities result in different CCIs and that the CCI under a certain modality differs across risk-groups.</p>\",\"PeriodicalId\":51883,\"journal\":{\"name\":\"Ship Technology Research\",\"volume\":\"63 1\",\"pages\":\"987-1000\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2017-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5602006/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Ship Technology Research\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1007/s10198-016-0843-9\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2016/11/14 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"ENGINEERING, MARINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ship Technology Research","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s10198-016-0843-9","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2016/11/14 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"ENGINEERING, MARINE","Score":null,"Total":0}
引用次数: 0
摘要
许多医疗保险计划都包含免赔额,为消费者提供成本控制激励(CCI),并抵消道德风险。政策制定者面临着实施特定费用分担设计的选择。决策过程中的指导原则之一可能是哪种设计能带来最强的 CCI。尽管有大量文献研究费用分担的效果,但特定费用分担设计的相对效果(如传统的免赔额与甜甜圈洞)在特定情况下大多不存在。本文旨在建立一个模拟模型,以近似分析不同免赔额模式对 CCI 的相对影响。我们认为,CCI 取决于医疗费用最终进入免赔额范围的概率,以及医疗费用最终进入免赔额范围后的预期医疗费用。我们的实证应用表明,不同的免赔额模式会导致不同的 CCI,而且不同风险群体在某种模式下的 CCI 也不同。
A method to simulate incentives for cost containment under various cost sharing designs: an application to a first-euro deductible and a doughnut hole.
Many health insurance schemes include deductibles to provide consumers with cost containment incentives (CCI) and to counteract moral hazard. Policymakers are faced with choices on the implementation of a specific cost sharing design. One of the guiding principles in this decision process could be which design leads to the strongest CCI. Despite the vast amount of literature on the effects of cost sharing, the relative effects of specific cost sharing designs-e.g., a traditional deductible versus a doughnut hole-will mostly be absent for a certain context. This papers aims at developing a simulation model to approximate the relative effects of different deductible modalities on the CCI. We argue that the CCI depends on the probability that healthcare expenses end up in the deductible range and the expected healthcare expenses given that they end up in the deductible range. Our empirical application shows that different deductible modalities result in different CCIs and that the CCI under a certain modality differs across risk-groups.