Cash benefits in long-term home care

• Published in: Health policy (Amsterdam) 2008-12, Vol.88 (2), p.209-221
• Main Authors: van den Berg, Bernard, Hassink, Wolter H.J
• Format: Article
• Language: English
• Subjects: Cash benefits; Community Participation; Consumer directed services; Consumer participation; Consumers; Cost-Benefit Analysis - statistics & numerical data; Demand-side subsidies; Direct payments; Health administration; Health economics; Health services; Home care; Home Care Services - economics; Humans; Internal Medicine; Long-Term Care; Long-term care Cash benefits Consumer directed services Demand-side subsidies Direct payments; National Health Programs - economics; Netherlands; Prices; Subsidies; Surveys and Questionnaires
• ISSN: 0168-8510; 1872-6054
• DOI: 10.1016/j.healthpol.2008.03.010

Abstract This paper tests empirically for differences in prices paid between parts of the cash benefit that clients may and not may keep when it is unspent. In The Netherlands, demand-side subsidies were introduced in 1996. Clients receive a cash benefit to purchase the type of home care (housework, personal care, support with mobility, organisational tasks or social support) they need from the care supplier of their choice (private care provider, regular care agency, commercial care agency or paid informal care provider). Furthermore, they negotiate with the care supplier about price and quantity. Our main findings are the following: (1) the component of the cash benefit that a client may not keep when it is unspent has a positive impact on the price of care. (2) In contrast, the components of the cash benefit a client may keep when it is unspent, have no or a negative impact on the price of care. Both results have important implications for designing health policy. If cash benefits are introduced in long-term home care in an attempt to make consumers more conscious about prices, it is only successful when consumers may keep the unspent part of the cash benefit.