Risk Sharing Between Competing Health Plans And Sponsors

In many countries, competing health plans receive capitation payments from a sponsor, whether government or a private employer. All capitation payment methods are far from perfect and have raised concerns about risk selection. Paying health plans partly on the basis of capitation and partly on the b...

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Bibliographic Details
Published in:Health Affairs 2001-05, Vol.20 (3), p.253-262
Main Authors: van Barneveld, Erik M, van Vliet, Rene C.J.A, van de Ven, Wynand P.M.M
Format: Article
Language:English
Subjects:
Capitation
Capitation Fee
Corporate sponsorship
Cost control
Economic Competition
Efficiency
Efficiency, Organizational
Employers
Fees & charges
Health care expenditures
Health care industry
Health care policy
Health maintenance organizations
Health Services Research
HMOs
Humans
Insurance policies
Insurance, Health - statistics & numerical data
Medicare
National Health Programs
Netherlands
Payment systems
Payments
Prescription drugs
Reimbursement, Incentive
Risk sharing
Risk Sharing, Financial - organization & administration
Statistical analysis
Studies
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Description
Summary:In many countries, competing health plans receive capitation payments from a sponsor, whether government or a private employer. All capitation payment methods are far from perfect and have raised concerns about risk selection. Paying health plans partly on the basis of capitation and partly on the basis of actual costs ("risk sharing") reduces plans' incentives for selection but sacrifices some incentives for efficiency. This paper summarizes our empirical research on Dutch health plans with respect to various forms of risk sharing. All sponsors can improve their payment systems by either implementing or changing their form of risk sharing.
ISSN:0278-2715
1544-5208
DOI:10.1377/hlthaff.20.3.253