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Theoretical and empirical occurence of cream-skimming - Evaluating Health Choice Skåne

Axelsson, Johan LU (2011) NEKM01 20112
Department of Economics
Abstract
The Swedish primary health care market has recently undergone a care choice reform where patients are allowed to choose which provider to be listed at. It has also opened up the market for private primary health care providers to a larger extent and a more competitive structure is created where capitation, a prospective and fixed reimbursement method, to varying degrees is used as a mean of provider reimbursement. Possible gains in efficiency and cost containment has to be weighed against the adverse incentives caused by capitation such as cream-skimming of patient according to individual characteristics and under-provision of medical services to all patients.
The theoretical and empirical occurrence of cream-skimming following the care... (More)
The Swedish primary health care market has recently undergone a care choice reform where patients are allowed to choose which provider to be listed at. It has also opened up the market for private primary health care providers to a larger extent and a more competitive structure is created where capitation, a prospective and fixed reimbursement method, to varying degrees is used as a mean of provider reimbursement. Possible gains in efficiency and cost containment has to be weighed against the adverse incentives caused by capitation such as cream-skimming of patient according to individual characteristics and under-provision of medical services to all patients.
The theoretical and empirical occurrence of cream-skimming following the care choice reform in Region Skåne, Health Choice Skåne, is what is being evaluated in this essay. The main findings are that the design of Health Choice Skåne provides some incentives for cream-skimming as almost all of the reimbursement is made up by capitation, a method not supported by the health economic literature. The empirical analysis does not give support of cream-skimming or other marginalizing behavior taking place on behalf of high-need patients or between public- and private health care centers. If anything, the case seems to be the opposite and the distribution of primary health care visits are now more equal with private health care centers, in general, acquiring a larger proportion of patients in high need of health care. (Less)
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author
Axelsson, Johan LU
supervisor
organization
course
NEKM01 20112
year
type
H1 - Master's Degree (One Year)
subject
keywords
Provider reimbursement, Health Choice Skåne, Health Economics, Cream-skimming
language
English
id
2201476
date added to LUP
2011-11-11 13:45:07
date last changed
2011-11-11 13:45:07
@misc{2201476,
  abstract     = {The Swedish primary health care market has recently undergone a care choice reform where patients are allowed to choose which provider to be listed at. It has also opened up the market for private primary health care providers to a larger extent and a more competitive structure is created where capitation, a prospective and fixed reimbursement method, to varying degrees is used as a mean of provider reimbursement. Possible gains in efficiency and cost containment has to be weighed against the adverse incentives caused by capitation such as cream-skimming of patient according to individual characteristics and under-provision of medical services to all patients.
	The theoretical and empirical occurrence of cream-skimming following the care choice reform in Region Skåne, Health Choice Skåne, is what is being evaluated in this essay. The main findings are that the design of Health Choice Skåne provides some incentives for cream-skimming as almost all of the reimbursement is made up by capitation, a method not supported by the health economic literature. The empirical analysis does not give support of cream-skimming or other marginalizing behavior taking place on behalf of high-need patients or between public- and private health care centers. If anything, the case seems to be the opposite and the distribution of primary health care visits are now more equal with private health care centers, in general, acquiring a larger proportion of patients in high need of health care.},
  author       = {Axelsson, Johan},
  keyword      = {Provider reimbursement,Health Choice Skåne,Health Economics,Cream-skimming},
  language     = {eng},
  note         = {Student Paper},
  title        = {Theoretical and empirical occurence of cream-skimming - Evaluating Health Choice Skåne},
  year         = {2011},
}