G2TT
来源类型Discussion paper
规范类型论文
来源IDDP12908
DP12908 Does the framing of patient cost-sharing incentives matter? The effects of deductibles vs. no-claim refunds
Tobias Klein; Martin Salm; Arthur Hayen
发表日期2018-05-04
出版年2018
语种英语
摘要Understanding how health care utilization responds to cost-sharing incentives is of central importance for providing high quality care and limiting the growth of costs. While there is compelling evidence that patients react to financial incentives, it is less well understood how and why specific aspects of the design of contracts shape the size of this reaction. In this paper, we focus on the question whether the framing of cost-sharing incentives has an effect on health care utilization. To study this we make use of a policy change that occurred in the Netherlands. Until 2007, patients received a no-claim refund if they consumed little or no health care; from 2008 onward there was a deductible instead. This means that very similar economic incentives were first framed in terms of smaller gains and later as losses. We use claims-level data for a broad sample from the Dutch population to estimate whether the reaction to economic incentives was affected by this. Our empirical approach exploits within-year variation using an instrumental variables approach while controlling for differences across years. Our central finding is that patients react to incentives much more strongly when they are framed in terms of losses. Simulations based on our estimates show that the effect on yearly spending is 8.6 percent. This suggests that discussions on the optimal design of cost-sharing incentives should not only involve coinsurance rates and cost-sharing limits, but also how these are presented to patients.
主题Labour Economics
关键词Patient cost-sharing Health insurance Framing
URLhttps://cepr.org/publications/dp12908-0
来源智库Centre for Economic Policy Research (United Kingdom)
资源类型智库出版物
条目标识符http://119.78.100.153/handle/2XGU8XDN/541719
推荐引用方式
GB/T 7714
Tobias Klein,Martin Salm,Arthur Hayen. DP12908 Does the framing of patient cost-sharing incentives matter? The effects of deductibles vs. no-claim refunds. 2018.
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